Individual
ANUSUYADEVI RAJEEVI BALAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4202 E FOWLER AVE, TAMPA, FL 33620-8000
(813) 974-2011
Mailing address
4202 E FOWLER AVE, TAMPA, FL 33620-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9319701
FL
363LF0000X
Family Nurse Practitioner
APRN9319701
FL
Other
Enumeration date
11/13/2018
Last updated
05/12/2023
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