Kancharla, Venkat Pavan Reddy

Kancharla, Venkat Pavan Reddy is an sole proprietor health care provider with primary practice located at 20 San Filippo Dr Se , Palm Bay FL 32909-2200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Kancharla, Venkat Pavan Reddy can be contacted via phone (321) 725-8300.

Contact Information

Primary practice address
20 San Filippo Dr Se Palm Bay FL 32909-2200
Phone: (321) 725-8300
Fax: (321) 725-1555
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X ME112590 Florida

Profile Details

NPI number 1205091758
LBN Legal business name Kancharla, Venkat Pavan Reddy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 24th, 2008
Last updated Jan 7th, 2019 - about 5 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 1205091758 NPPES
Florida MEDICAID 004704200

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