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1902068919
KISHORE THEKKE ADIYAT
MIAMI, FL
NPI
1902068919
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: FL TRN12098)
Enumeration Date
2008-06-30
Last Update Date
2008-06-30
Business Address
-- KISHORE THEKKE ADIYAT MD
1611 NW 12TH AVE
MIAMI, FL 33136-1005
Phone number: 305-243-6837
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Mailing Address
-- KISHORE THEKKE ADIYAT MD
PO BOX 16960
MIAMI, FL 33101-6960
Phone number: 305-243-6837
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