Provider Demographics
NPI:1356537591
Name:MEKAPATI, SURESH BABU
Entity type:Individual
Prefix:DR
First Name:SURESH
Middle Name:BABU
Last Name:MEKAPATI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 ASHFORD OAKS DR
Mailing Address - Street 2:APT # 205
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-5509
Mailing Address - Country:US
Mailing Address - Phone:407-339-3309
Mailing Address - Fax:
Practice Address - Street 1:703 ASHFORD OAKS DR
Practice Address - Street 2:APT # 205
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-5509
Practice Address - Country:US
Practice Address - Phone:407-339-3309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist