| Anu R Tatambhotla Md Pa | |
|
4049 S Ohio Ave Homosassa FL 34446-1138 | |
| (352) 628-1000 | |
| (352) 628-1120 |
| Full Name | Anu R Tatambhotla Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 4049 S Ohio Ave, Homosassa, Florida |
| Authorized Official Name and Position | Anu R Tatambhotla (OWNER) |
| Authorized Official Contact | 3526281000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anu R Tatambhotla Md Pa Po Box 5069 Homosassa Springs FL 34447-5069 Ph: (352) 628-1000 | Anu R Tatambhotla Md Pa 4049 S Ohio Ave Homosassa FL 34446-1138 Ph: (352) 628-1000 |
| NPI Number | 1114152188 |
|---|---|
| Provider Enumeration Date | 05/20/2009 |
| Last Update Date | 05/20/2009 |
| Medicare PECOS PAC ID | 1759431190 |
|---|---|
| Medicare Enrollment ID | O20090605000518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114152188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME73760 (Florida) | Primary |
| 363LF0000X | Nurse Practitioner - Family | FLARNP2962952 (Florida) | Secondary |
| Provider Name | Anu Tatambhotla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477619559 PECOS PAC ID: 2860542206 Enrollment ID: I20090605000502 |
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