| NPI | 1871005728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANGANATHA POTU Owner 352-228-8429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME36819) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2017-11-01 |