Provider Demographics
NPI:1003048687
Name:KOLLU, VIDYA SAGAR (MD)
Entity type:Individual
Prefix:
First Name:VIDYA
Middle Name:SAGAR
Last Name:KOLLU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 SW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8167
Mailing Address - Country:US
Mailing Address - Phone:352-450-3222
Mailing Address - Fax:352-450-3223
Practice Address - Street 1:1813 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8167
Practice Address - Country:US
Practice Address - Phone:352-450-3222
Practice Address - Fax:352-450-3223
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME14878207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease