NPI 1508438722 · live from the CMS NPI Registry
Srikanth Adidam Venkata, MD
Psychiatry & Neurology, Neurology in Jacksonville, FL. National Provider Identifier 1508438722, active.
NPI record
| NPI | 1508438722 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 4500 San Pablo Rd S, Jacksonville, FL 32224 |
| Practice phone | 904-953-2000 |
| Mailing address | 1 Brookdale Plz, Brooklyn, NY 11212 |
| Enumerated | July 15, 2021 |
| Last updated | April 17, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology primary | 2084N0400X | ME173489 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.