Reddy, Prasanthi

Reddy, Prasanthi is an sole proprietor health care provider with primary practice located at 4788 Hodges Blvd Building B, Suite 108, Jacksonville FL 32224-7222. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Reddy, Prasanthi can be contacted via phone (904) 223-9100.

Contact Information

Primary practice address
4788 Hodges Blvd Building B, Suite 108 Jacksonville FL 32224-7222
Phone: (904) 223-9100
Fax: (904) 223-9282
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X ME91195 Florida
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME9115 Florida

Profile Details

NPI number 1386620870
LBN Legal business name Reddy, Prasanthi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 16th, 2005
Last updated Nov 12th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386620870 NPPES
Florida MEDICAID 273107000

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