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Organization

KANUMURI MEDICAL GROUP PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NAGESWARARO V KANUMURI MD (PRESIDENT/PHYSICIAN)
(863) 402-0064
Entity
Organization

Contact information

Practice address
410 S 11TH ST, LAKE WALES, FL 33853-4203
(863) 402-0064
(866) 746-1525
Mailing address
PO BOX 2327, LAKE WALES, FL 33859-2327
(863) 402-0064
(866) 746-1525

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
FL

Other

Enumeration date
05/26/2006
Last updated
10/18/2007
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