Provider Demographics
NPI:1912921024
Name:REDDY, ANOOP K (MD)
Entity Type:Individual
Prefix:DR
First Name:ANOOP
Middle Name:K
Last Name:REDDY
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 1:4446 E FLETCHER AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4942
Mailing Address - Country:US
Mailing Address - Phone:813-558-8878
Mailing Address - Fax:813-558-0259
Practice Address - Street 1:4446 E FLETCHER AVE
Practice Address - Street 2:SUITE E
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4942
Practice Address - Country:US
Practice Address - Phone:813-558-8878
Practice Address - Fax:813-558-0259
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00689922084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6959Medicare ID - Type Unspecified
FLG36959Medicare UPIN