Sureka Bollepalli, M.D.

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

ME 106517 Issued in FL

Practice address

12901 Bruce B Downs Blvd
Usf Diabetes Center, MDC 62
Tampa, FL 33612-4742

Phone

(813) 396-2580

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• Freedom Health HMO Network

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1871700948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD",
            "address_2": "USF DIABETES CENTER, MDC 62",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742",
            "telephone_number": "813-396-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLEPALLI",
        "first_name": "SUREKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME 106517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002214100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "149KF",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bolesta Center, Inc.
• Kassidy Marie Boliek-Gelb
• Kelly Marie Bolin, APRN
• Claudia Bolivar, COTA/L
• Rishi Raghavendar Bolla
• David Anthony Bollinger, R.EEGT,
• Estefany Sabrina Bologna Nino, PHD
• Dani Bologna
• Ifeoluwa Bolujo, MD
• Katherine B Bombly, DO

• Pediatric Endocrinology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Pediatric Endocrinology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.