Provider Demographics
NPI:1669402459
Name:VATTIGUNTA, LOKESH V (MD)
Entity type:Individual
Prefix:
First Name:LOKESH
Middle Name:V
Last Name:VATTIGUNTA
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 1:119 TALAVERA PLACE
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6221
Mailing Address - Country:US
Mailing Address - Phone:561-433-1004
Mailing Address - Fax:561-616-6408
Practice Address - Street 1:119 TALAVERA PLACE
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-6221
Practice Address - Country:US
Practice Address - Phone:561-433-1004
Practice Address - Fax:561-616-6408
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine