| NPI | 1407159031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYA PRAKASH GADIKOTA Md 352-281-4323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME106624) |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2011-11-10 |