Provider Demographics
NPI:1265427728
Name:HARIACHAR, SRINIVAS K (MD)
Entity type:Individual
Prefix:DR
First Name:SRINIVAS
Middle Name:K
Last Name:HARIACHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14134 NEPHRON LN
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6504
Mailing Address - Country:US
Mailing Address - Phone:727-863-5418
Mailing Address - Fax:727-869-8626
Practice Address - Street 1:14134 NEPHRON LN
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6504
Practice Address - Country:US
Practice Address - Phone:727-863-5418
Practice Address - Fax:727-869-8626
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79049207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
593068073OtherHUMANA MILITARY
PRO0057OtherQUALITY/DELTA
01244OtherUNIVERSAL
222906OtherWELLCARE
3399688OtherGHI
0007944175OtherAETNA
1018OtherOPTIMUM
271642OtherAV-MED
390007268OtherMEDICARE RR
4574196OtherCIGNA
593068073OtherSOUTHCARE
593068073OtherPCHS
10501501OtherCITRUS HEALTH CARE
FL260661500Medicaid
593068073OtherHUMANA
1856710OtherCCN
000810178645OtherPRINCIPAL
1856710OtherFIRST HEALTH
3399688OtherGHI
FL260661500Medicaid