Provider Demographics
NPI:1992768436
Name:NIMMAGADDA, SAROJINI (MD)
Entity type:Individual
Prefix:DR
First Name:SAROJINI
Middle Name:
Last Name:NIMMAGADDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SAROJINI
Other - Middle Name:
Other - Last Name:NIMMAGADDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7551 FOREST OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-2437
Mailing Address - Country:US
Mailing Address - Phone:352-540-6800
Mailing Address - Fax:352-688-5097
Practice Address - Street 1:7551 FOREST OAKS BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-2437
Practice Address - Country:US
Practice Address - Phone:352-540-6800
Practice Address - Fax:352-688-5097
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 45048208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3731502 000Medicaid
FL3731502 000Medicaid