| NPI | 1427383512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLIKARJUNA NANDYALA Owner 813-884-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0070271) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2013-01-30 |