Individual
DR. IVANA GAGULA-LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
201 14TH ST SW, LARGO, FL 33770-3133
(561) 699-2954
Mailing address
201 14TH ST SW, LARGO, FL 33770-3133
(561) 699-2954
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS16761
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107446400
—
FL
Enumeration date
06/07/2016
Last updated
02/03/2025
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