Provider Demographics
NPI:1811288863
Name:SISTA, SWATHI KAMESWARI (MD)
Entity type:Individual
Prefix:
First Name:SWATHI
Middle Name:KAMESWARI
Last Name:SISTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SWATHI
Other - Middle Name:KAMESWARI
Other - Last Name:SISTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD MPH
Mailing Address - Street 1:2415 N ORANGE AVE STE 502
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5503
Mailing Address - Country:US
Mailing Address - Phone:407-303-2801
Mailing Address - Fax:407-303-2805
Practice Address - Street 1:2415 N ORANGE AVE STE 502
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5503
Practice Address - Country:US
Practice Address - Phone:407-303-2801
Practice Address - Fax:407-303-2805
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146134207RE0101X
MI4301099241207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism