| NPI | 1174951891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJITH KUMAR POTLURI Owner 407-962-7449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: FL ME 115004) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME 115004) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2013-10-15 |