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Individual

SAMPATHKUMAR SHANMUGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
755 STIRLING CENTER PL, LAKE MARY, FL 32746-5714
(407) 333-1718
(407) 333-1633
Mailing address
755 STIRLING CENTER PL, LAKE MARY, FL 32746-5714
(407) 333-1718
(407) 333-1633

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME50877
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
371422500
FL
Enumeration date
05/31/2005
Last updated
03/25/2011
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