Organization
ANU R TATAMBHOTLA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANU R TATAMBHOTLA MD (OWNER)
(352) 628-1000
Entity
Organization
Contact information
Practice address
4049 S OHIO AVE, HOMOSASSA, FL 34446-1138
(352) 628-1000
(352) 628-1120
Mailing address
PO BOX 5069, HOMOSASSA SPRINGS, FL 34447-5069
(352) 628-1000
(352) 628-1120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME73760
FL
363LF0000X
Family Nurse Practitioner
FLARNP2962952
FL
Other
Enumeration date
05/20/2009
Last updated
05/20/2009
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