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Organization
MC MEDICAL LLC
Active
Organization
MC MEDICAL LLC
Active
Other names
Walmart Health 2387
Organization subpart
No
Provider details
NPI number
Authorized official
SOUJANYA PULLURU (OWNER)
(630) 545-4046
Entity
Organization
Contact information
Practice address
11108 CAUSEWAY BLVD, BRANDON, FL 33511
(813) 688-9416
Mailing address
702 SW 8TH ST # MS 0445, BENTONVILLE, AR 72716-6209
(479) 258-2080
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
231H00000X
Audiologist
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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