# FLORIDA INTERNAL MEDICINE, PL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912954439
- **Authorized official:** DR. DWARAKNADH R BANALA M.D. (OWNER)
- **Authorized official phone:** (352) 365-0099

## Contact information

- **Practice address:** 620 S LAKE ST, SUITE\# 6, LEESBURG, FL 34748-6059
- **Practice address phone:** (352) 365-0099
- **Practice address fax:** (352) 315-0578
- **Mailing address:** 3016 PALERMO CT, MOUNT DORA, FL 32757-6527
- **Mailing address phone:** (352) 383-8209
- **Mailing address fax:** (352) 383-8209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | ME80590 | FL | Yes |

## Other

- **Enumeration date:** 05/29/2006
- **Last updated:** 01/10/2011