Individual
PRADEEP VANGURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, ATC
Contact information
Practice address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-8166
Mailing address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-8166
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL289
FL
Other
Enumeration date
12/15/2015
Last updated
12/15/2015
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