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Individual

DR. AVANTICA GONDI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1818 HARDEN BLVD STE 120, LAKELAND, FL 33803-1813
(863) 210-5640
(863) 210-5716
Mailing address
1818 HARDEN BLVD, STE 120, LAKELAND, FL 33803-1812
(863) 210-5640
(863) 210-5716

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 104474
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001481700
FL
Enumeration date
06/24/2008
Last updated
01/19/2017
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