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Organization
RUPALA GHANSHYAM LLC
Active
Organization
RUPALA GHANSHYAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STAN MYERS (CREDENTIALING MANAGER)
(332) 330-3903
Entity
Organization
Contact information
Practice address
828 VENTURI CT, MELBOURNE, FL 32940-1797
(321) 364-2080
Mailing address
828 VENTURI CT, MELBOURNE, FL 32940-1797
(321) 364-2080
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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