Provider Demographics
NPI:1538156609
Name:NALLAMSHETTY, ADINARAYANAMURTHY (MD)
Entity type:Individual
Prefix:DR
First Name:ADINARAYANAMURTHY
Middle Name:
Last Name:NALLAMSHETTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 CITRUS TOWER BLVD
Mailing Address - Street 2:BLDG # 1
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6803
Mailing Address - Country:US
Mailing Address - Phone:352-242-1500
Mailing Address - Fax:352-242-0053
Practice Address - Street 1:3155 CITRUS TOWER BLVD
Practice Address - Street 2:BLDG # 1
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6803
Practice Address - Country:US
Practice Address - Phone:352-242-1500
Practice Address - Fax:352-242-0053
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME737500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260240700Medicaid