| Sujatha Borra Md Pa | |
|
13333 N 56th St Tampa FL 33617-1161 | |
| (813) 983-0894 | |
| Not Available |
| Full Name | Sujatha Borra Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 13333 N 56th St, Tampa, Florida |
| Authorized Official Name and Position | Sujatha Reddy Borra (PRESIDENT) |
| Authorized Official Contact | 8139830894 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sujatha Borra Md Pa 13333 N 56th St Tampa FL 33617-1161 Ph: (813) 983-0894 | Sujatha Borra Md Pa 13333 N 56th St Tampa FL 33617-1161 Ph: (813) 983-0894 |
| NPI Number | 1235328519 |
|---|---|
| Provider Enumeration Date | 10/23/2007 |
| Last Update Date | 01/23/2025 |
| Certification Date | 01/23/2025 |
| Medicare PECOS PAC ID | 7719904911 |
|---|---|
| Medicare Enrollment ID | O20051027000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235328519 | NPI | - | NPPES |
| 273907100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME86603 (Florida) | Primary |
| Provider Name | Sujatha Reddy Borra |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104811462 PECOS PAC ID: 6709784358 Enrollment ID: I20031222000192 |
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