Organization
PSYCHIATRIC CONSULTANTS OF CENTRAL FLORIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJITH KUMAR POTLURI M.D. (OWNER)
(407) 962-7449
Entity
Organization
Contact information
Practice address
3389 W VINE ST, SUITE 304, KISSIMMEE, FL 34741-4665
(407) 962-7449
(407) 563-5491
Mailing address
3389 W VINE ST, SUITE 304, KISSIMMEE, FL 34741-4665
(407) 962-7449
(407) 563-5491
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
ME 115004
FL
2084P0805X
Geriatric Psychiatry Physician
ME 115004
FL
Other
Enumeration date
10/15/2013
Last updated
10/15/2013
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