1356040026 NPI number — FOUNDCARE, INC.

Table of content: SRINIVASA REDDY MADIREDDY M.D (NPI 1033313069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356040026 NPI number — FOUNDCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOUNDCARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356040026
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2330 S CONGRESS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33406-7608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-432-5849
Provider Business Mailing Address Fax Number:
561-432-9732

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 NW AVENUE L STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLE GLADE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33430-1729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-996-7059
Provider Business Practice Location Address Fax Number:
561-996-1567
Provider Enumeration Date:
03/01/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SILVA
Authorized Official First Name:
ELISHA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF CREDENTIALING
Authorized Official Telephone Number:
561-432-5849

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)