Supradeep Shree Venkata Madduri
Urology • Jacksonville, FL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Supradeep Madduri has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Supradeep Madduri was a registered Urology practicing in Jacksonville, FL. Throughout an active medical career spanning 1 years, Supradeep Madduri provided care at the practice location at 4500 SAN PABLO RD S until profile deactivation on 2022-02-02.
Practice Location & Contact Primary Location
4500 San Pablo Rd S
Jacksonville, FL 322241865
Specialty Benchmarks & Practice Insights
Comparative analytics for Urology in Jacksonville, FL
Practicing in Jacksonville, FL (1082 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
CMS Verified: 2026-08-09NUCC Taxonomy Code: 208800000X
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Physician Assistant
Physician Assistant (Certified), Master of Public Health
Internal Medicine - Gastroenterology
Doctor of Medicine (M.D.)
Orthopaedic Surgery
Doctor of Medicine (M.D.)
Internal Medicine
Doctor of Medicine (M.D.)
Hospitalist
Doctor of Medicine (M.D.)
Nurse Anesthetist, Certified Registered
Certified Registered Nurse Anesthetist
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Urology (License #46196 in FL)
Registered at 4500 SAN PABLO RD S, JACKSONVILLE, FL 322241865 (Tel: 9049532000)
Registered at PO BOX 860912, MINNEAPOLIS, MN 554860912 (Tel: 9049532000)
Recorded as SUPRADEEP MADDURI
Student in an Organized Health Care Education/Training Program
Record deactivated on February 02, 2022
Registered at 101 MANNING DR, CHAPEL HILL, NC 275144220 (Tel: 9849743014)
NPI status registered as active in NPPES database
Registered at 101 MANNING DR, CHAPEL HILL, NC 275144220 (Tel: 8283201615)
Registered at 1840 9TH ST NW, HICKORY, NC 286011208 (Tel: 8283201615)
Recorded as SUPRADEEP MADDURI
Pharmacy Technician (License #30048194 in NC)
First registered as active Individual Practitioner in NPPES Database.
Patient & Community Reviews
Verified patient ratings, medical care experiences, and facility photos
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NPI Administrative Meta
Mailing Address
Po Box 860912
Minneapolis, MN 554860912
Phone: 9049532000
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