| NPI | 1497146716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORAVANGALA V SUNDARESH Owner 727-457-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME0042812) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2015-02-09 |