SUREKA BOLLEPALLI (NPI# 1871700948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871700948 |
| Entity Type | Individual |
| Full Name | SUREKA BOLLEPALLI |
| Credential | M.D. |
| Practice Address |
12901 Bruce B Downs Blvd Usf Diabetes Center, Mdc 62 Tampa FL 33612-4742 |
| Mailing Address |
Po Box 917770 Orlando FL 32891-7770 |
| Practice Telephone | 8133962580 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2010-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
ME 106517 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 002214100 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | 149KF | 01 |
| Street Address |
12901 BRUCE B DOWNS BLVD USF DIABETES CENTER, MDC 62 |
| City | TAMPA |
| State | FL |
| Zip Code | 33612-4742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629076799 | Gonzalo Mantilla | Pediatrics | 12901 Bruce B Downs Blvd, Mdc 15, Tampa, FL 33612-4742 | 2005-07-12 |
| 1538796784 | Samia Valeria Ozorio Dutra | Registered Nurse | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2020-03-26 |
| 1255966289 | Jessica Huang | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2020-03-10 |
| 1487218764 | Chelsea Gebs Black | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612-4742 | 2019-04-23 |
| 1609430925 | Kathryn Elizabeth Rudibaugh | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-23 |
| 1467015883 | Thomas Cole | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2019-04-22 |
| 1417510751 | Kelly Powell | Physician Assistant | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-22 |
| 1700347283 | Kristopher Johnson | Nurse Practitioner | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4799 | 2019-03-27 |
| 1366909129 | Derrik Jose Diaz Navarro | Specialist/Technologist | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2019-02-27 |
| 1346717717 | Kyle William Woodward | Specialist/Technologist | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4799 | 2018-10-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760460992 | Tsu-hui Lin | Pediatrics | 3001 W Martin Luther King Boulevard, Tampa, FL 33607-6307 | 2006-01-06 |
| 1154564631 | Danielle Gomez Reynolds | Pediatrics | 2 Tampa General Cir, Tampa, FL 33606-3603 | 2009-04-13 |
| 1669667556 | Grace Castro Dougan | Pediatrics | 3001 W. Martin Luther King Jr. Blvd, 3rd Floor Medical Arts Building, Tampa, FL 33607 | 2007-09-13 |
| 1932309085 | Shuchi Shah | Pediatrics | 12220 Bruce B Downs Blvd, Tampa, FL 33612 | 2007-07-18 |
| 1962434662 | Henry Rodriguez | Pediatrics | 13330 Usf Laurel Dr, Tampa, FL 33612-6601 | 2006-07-06 |
| 1962481127 | Terry Joe Declue | Pediatrics | 3001 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607-6307 | 2006-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891359998 | Kids and Families Medical Clinic LLC | Pediatrics | 12086 Fort Caroline Rd Ste 404, Jacksonville, FL 32225-7640 | 2019-04-24 |
| 1942438767 | Lisa Erin Kenigsberg Fechter | Pediatrics | 9600 W Sample Rd Ste 505, Coral Springs, FL 33065-4037 | 2009-07-01 |
| 1063671212 | Miladys Miriam Palau Collazo | Pediatrics | 9401 Sw Discovery Way Ste 102, Port Saint Lucie, FL 34987-2381 | 2008-06-03 |
| 1043417421 | Omar Dean Hudson | Pediatrics | 1223 Gateway Dr Ste 1g, Melbourne, FL 32901-2607 | 2007-06-29 |
| 1790987964 | Konda Mohan Reddy | Pediatrics | 1801 Lee Rd Ste 170, Winter Park, FL 32789 | 2007-06-01 |
| 1477764207 | Sissi Cossio | Pediatrics | 7605 N State Rd 7, Parkland, FL 33067 | 2007-05-24 |
| 1588701379 | Samuel M Freedman | Pediatrics | 601 N Flamingo Rd Ste 207, Pembroke Pines, FL 33028-1009 | 2007-01-31 |
| 1326116443 | Kelly J Seiler | Pediatrics | 10383 Hagen Ranch Rd Ste 200, Boynton Beach, FL 33437-3782 | 2006-11-30 |
| 1447324744 | Luis E Gonzalez-mendoza | Pediatrics | 3100 Sw 62nd Ave Ste 122, Miami, FL 33155-3009 | 2006-11-20 |
| 1538240320 | Amid Habib | Pediatrics | 789 Douglas Ave, Suite 137, Altamonte Springs, FL 32714 | 2006-10-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.