Provider Demographics
NPI:1104951888
Name:KUMBHA, PRAMATI REDDY (MD)
Entity type:Individual
Prefix:DR
First Name:PRAMATI
Middle Name:REDDY
Last Name:KUMBHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2323 CURLEW RD
Mailing Address - Street 2:STE 6E
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-9330
Mailing Address - Country:US
Mailing Address - Phone:727-789-2922
Mailing Address - Fax:727-787-4288
Practice Address - Street 1:6239 FORT KING RD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2530
Practice Address - Country:US
Practice Address - Phone:813-783-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88457207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2064Medicare ID - Type Unspecified