Male or Other

Dr. Mallikarjuna Nandyala M.D.

Internal Medicine Physician in Tampa, FL(View on Map)

Full Name

Dr. Mallikarjuna Nandyala M.D.

NPI Number

1023081676

NPI Type

Individual Provider

Gender

Male

Enumeration Date

02/13/2006

Specialties

(Taxonomies)

Code

207R00000X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

ME70271

Contact
Information

Purpose

Mailing
Location

Address

14749 WATERCHASE BLVD
13642 W HILLSBOROUGH AVE

City

Tampa
Tampa

State

FL
FL

Postal Code

33626-3318
33635-9638

Country

US
US

Telephone Number

(813) 884-0222
(813) 884-0222

Identifiers

Identifier

2509053
110244550
113934
250560600
243309
31236
ME0070271
2513301
139275BJ
Unknown

Identifier State

FL
FL
FL
FL
FL
FL
FL
FL
FL
Unknown

Identifier Issuer

AETNA
RAILROAD MEDICARE
AMERIGROUP
Unknown
AVMED
BLUE CROSS BLUE SHIELD
MEDICAL STATE LICENSE
GHI
PREFERRED CARE
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/17/2013

Provider Address

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