Provider Demographics
NPI:1194229567
Name:KAMIREDDI, PRASUNA DEVI (MBBS)
Entity type:Individual
Prefix:
First Name:PRASUNA
Middle Name:DEVI
Last Name:KAMIREDDI
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 RACHEL DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3789
Mailing Address - Country:US
Mailing Address - Phone:860-906-6002
Mailing Address - Fax:
Practice Address - Street 1:720 W OAK ST STE 201
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4998
Practice Address - Country:US
Practice Address - Phone:407-518-2751
Practice Address - Fax:407-518-3923
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program