Organization
KANUMURI MEDICAL GROUP PA
Active
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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