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1912600438
GAUTAM KANAKAMEDALA
GAINESVILLE, FL
NPI
1912600438
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-03-23
Last Update Date
2023-03-23
Business Address
GAUTAM KANAKAMEDALA DO
6500 W NEWBERRY RD
GAINESVILLE, FL 32605-4309
Phone number: 352-333-5982
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Mailing Address
GAUTAM KANAKAMEDALA DO
1147 NW 64TH TER
GAINESVILLE, FL 32605-4218
Phone number: 352-333-5982
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