Provider Demographics
NPI:1134243611
Name:KAZA, MADHAVI BATTINENI (DO)
Entity type:Individual
Prefix:DR
First Name:MADHAVI
Middle Name:BATTINENI
Last Name:KAZA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16299 BRISTOL POINTE DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2364
Mailing Address - Country:US
Mailing Address - Phone:561-926-1720
Mailing Address - Fax:
Practice Address - Street 1:16299 BRISTOL POINTE DR
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2364
Practice Address - Country:US
Practice Address - Phone:561-926-1720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237879-12085R0202X
FLOS104032085R0202X
NJ25MB086945002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology