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1801845607
LATHA SHIVASHANKAR
JACKSONVILLE, FL
NPI
1801845607
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
208000000X Pediatrics
(Licence: FL ME53102)
Enumeration Date
2006-05-09
Last Update Date
2012-11-29
Business Address
-- LATHA SHIVASHANKAR MD
11512 LAKE MEAD AVE SUITE 201
JACKSONVILLE, FL 32256-9680
Phone number: 904-998-1448
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Mailing Address
-- LATHA SHIVASHANKAR MD
11512 LAKE MEAD AVE SUITE 201
JACKSONVILLE, FL 32256
Phone number: 904-998-1448
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