Individual
VISAL NUMRUNGROAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4738 GRAND BLVD, SUITE D, NEW PORT RICHEY, FL 34652-5170
(727) 848-1274
(727) 849-6409
Mailing address
4738 GRAND BLVD, SUITE D, NEW PORT RICHEY, FL 34652-5170
(727) 848-1274
(727) 849-6409
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME0086087
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268824700
—
FL
Enumeration date
01/25/2006
Last updated
06/15/2010
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