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Dr. Vidyasagar Reddy Vangala
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. Vidyasagar Reddy Vangala |
| Gender: | M |
| Provider License Number If Given: | ME82811 |
NPI Information:
| NPI: | 1679568133 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 1/22/2014 |
Provider Business Mailing Address:
| Address: | 2504 SAND MINE RD Davenport, FL 33897 |
| Phone Number: | 8634197645 |
| Fax Number: | 8634197655 |
Provider Business Practice Location Address:
| Address: | 2504 SAND MINE RD Davenport, FL 33897 |
| Phone Number: | 8634197645 |
| Fax Number: | 8634197655 |
Provider Taxonomy:
| Primary: | 2084P0800X |
| Secondary (if any): | |
| State: | FL |
