Provider Demographics
NPI:1982673000
Name:REDDY, ASHWINI (MD)
Entity Type:Individual
Prefix:
First Name:ASHWINI
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34661 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2152
Mailing Address - Country:US
Mailing Address - Phone:727-787-1350
Mailing Address - Fax:727-754-8987
Practice Address - Street 1:34661 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2152
Practice Address - Country:US
Practice Address - Phone:727-787-1350
Practice Address - Fax:727-754-8987
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036112731207R00000X
IN01067302207RE0101X
FLME114703207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14PY2OtherBCBS
FL6761609OtherCIGNA
FL008733600Medicaid
FL14PY2OtherBCBS
FL008733600Medicaid