Provider Demographics
NPI:1306063466
Name:VINDHYA, NAVEENA (MD)
Entity type:Individual
Prefix:DR
First Name:NAVEENA
Middle Name:
Last Name:VINDHYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NAVEENA
Other - Middle Name:
Other - Last Name:VINDHYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:HOUSE# 4-139, RAMAYYAVAARI VEEDHI
Mailing Address - Street 2:
Mailing Address - City:VEERAVALLI
Mailing Address - State:ANDHRA PRADESH
Mailing Address - Zip Code:521110
Mailing Address - Country:IN
Mailing Address - Phone:191865-622-1133
Mailing Address - Fax:
Practice Address - Street 1:7631 SOUTHERN BROOK BND
Practice Address - Street 2:APT # 104
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-1820
Practice Address - Country:US
Practice Address - Phone:813-412-1728
Practice Address - Fax:813-412-1728
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242173208000000X, 2080H0002X
FLME 994012080H0002X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2808986 00Medicaid