Provider Demographics
NPI:1295053239
Name:CHERABUDDI, KARTIKEYA (MD)
Entity type:Individual
Prefix:DR
First Name:KARTIKEYA
Middle Name:
Last Name:CHERABUDDI
Suffix:
Gender:M
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:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:813-821-8038
Mailing Address - Fax:813-974-0483
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:DIVISION OF INFECTIOUS DISEASES, DEPARTMENT OF MEDICINE
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-5481
Practice Address - Fax:352-392-6481
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117014207R00000X, 207RI0200X
IL036124994207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009642000Medicaid
FL14R4EOtherBLUE CROSS BLUE SHIELD