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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

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