Basic Information
| Provider Information | |||||||||
| NPI: | 1265403000 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SREENATH | ||||||||
| FirstName: | BELUR | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3901 66TH ST N | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337094911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273455500 | ||||||||
| FaxNumber: | 7273456164 | ||||||||
| Practice Location | |||||||||
| Address1: | 3901 66TH ST N | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337094911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273455500 | ||||||||
| FaxNumber: | 7273456164 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 11/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | ME38516 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 62311 | 01 | BCBS | OTHER | 01188 | 01 | WELLCARE | OTHER | 10694701 | 01 | CITRUS HEALTHCARE | OTHER | 849 | 01 | UNIVERSAL HEALTHCARE | OTHER | 080961 | 01 | AV MED | OTHER | 2905018 | 01 | UNITED HEALTHCARE | OTHER | 9637381 | 01 | GHI | OTHER | 0178423-006 | 01 | CIGNA | OTHER | 1035401 | 01 | CAREPLUS | OTHER | 225570 | 01 | AMERIGROUP | OTHER | 4238666 | 01 | AETNA | OTHER |