Basic Information
| Provider Information | |||||||||
| NPI: | 1790215903 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUDUR | ||||||||
| FirstName: | UMA | ||||||||
| MiddleName: | MAHESH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13067 N TELECOM PKWY | ||||||||
| Address2: | |||||||||
| City: | TEMPLE TERRACE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336370926 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1431 SW 1ST AVE | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344716500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3524018311 | ||||||||
| FaxNumber: | 3524018313 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | ME146982 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | ME146982 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.