| NPI | 1790761393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANJANAYA PRASAD KORLIPARA President 772-429-5201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1107) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2012-02-20 |