Pothuraju, Venkata R
Pothuraju, Venkata R is an individual health care provider with primary practice located at 4930 E Lake Mary Blvd , Sanford FL 32771-5003. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Pothuraju, Venkata R can be contacted via phone (407) 322-8645.Contact Information
Primary practice address
4930 E Lake Mary Blvd
Sanford FL 32771-5003
Phone: (407) 322-8645
Fax: (407) 330-5074
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME103700 | Florida |
Profile Details
| NPI number | 1194843763 |
|---|---|
| LBN Legal business name | Pothuraju, Venkata R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 26th, 2007 |
| Last updated | Sep 3rd, 2020 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194843763 | NPPES |
| Florida | MEDICAID | 000998900 |
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