| NPI | 1396282646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KUCHAKULLA N REDDY Medical Director 352-732-9844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME66726) |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207L00000X Anesthesiology (Licence: FL ME78743) | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |