Individual
MS. BASDAI SIRJU SOOKOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CCM
Contact information
Practice address
1420 MALLORY SAIL PL, BRANDON, FL 33511-2387
(813) 727-7131
Mailing address
1420 MALLORY SAIL PL, BRANDON, FL 33511-2387
(813) 727-7131
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
9216102
FL
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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