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Individual

ANITA EKAMBARAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
555 W SR 434, MP SS ADMIN, LONGWOOD, FL 32750-5119
(321) 842-2994
(407) 767-5801
Mailing address
555 W SR 434, MP SS ADMIN, LONGWOOD, FL 32750-5119
(321) 842-2994
(407) 767-5801

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME82459
FL
208M00000X
Hospitalist Physician
ME82459
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
262185100
FL
01
ME82459
MEDICAL LICENSE
FL
Enumeration date
07/31/2006
Last updated
11/11/2016
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