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Organization
RAVISHANKAR L RAO M D PA
Active
Organization
RAVISHANKAR L RAO M D PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVISHANKAR L RAO MD (OWNER/ DOCTOR)
(352) 796-2909
Entity
Organization
Contact information
Practice address
15435 CORTEZ BLVD, BROOKSVILLE, FL 34613-6113
(352) 796-2909
(352) 796-8196
Mailing address
15435 CORTEZ BLVD, BROOKSVILLE, FL 34613-6113
(352) 796-2909
(352) 796-8196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME 0063596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257221400
—
FL
Enumeration date
09/24/2007
Last updated
03/06/2012
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