| Dr Manohar G Reddy Md Pa | |
|
2551 W Eau Gallie Blvd Suite 101 Melbourne FL 32935-8954 | |
| (321) 752-5544 | |
| (321) 752-5957 |
| Full Name | Dr Manohar G Reddy Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2551 W Eau Gallie Blvd, Melbourne, Florida |
| Authorized Official Name and Position | Manohar G Reddy (PHYSICIAN/OWNER) |
| Authorized Official Contact | 3217525544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Manohar G Reddy Md Pa 2551 W Eau Gallie Blvd Suite 101 Melbourne FL 32935-8954 Ph: (321) 752-5544 | Dr Manohar G Reddy Md Pa 2551 W Eau Gallie Blvd Suite 101 Melbourne FL 32935-8954 Ph: (321) 752-5544 |
| NPI Number | 1053510305 |
|---|---|
| Provider Enumeration Date | 07/17/2007 |
| Last Update Date | 08/28/2007 |
| Medicare PECOS PAC ID | 4385736065 |
|---|---|
| Medicare Enrollment ID | O20070827000149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053510305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0073885 (Florida) | Primary |
| Provider Name | Manohar G Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356385165 PECOS PAC ID: 7911951439 Enrollment ID: I20050308000915 |
| Provider Name | Rebecca Lisa Womack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942470612 PECOS PAC ID: 3476749854 Enrollment ID: I20101124000495 |
| Provider Name | Naomi Dawn Perri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992145478 PECOS PAC ID: 9739484973 Enrollment ID: I20160225000896 |
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