Organization
HGA LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMAKRISHNA P KANURI M.D. (MGRM)
(352) 597-1206
Entity
Organization
Contact information
Practice address
12190 CORTEZ BLVD, BROOKSVILLE, FL 34613-5578
(352) 597-1206
(352) 597-9715
Mailing address
12190 CORTEZ BLVD, BROOKSVILLE, FL 34613-5578
(352) 597-1206
(352) 597-9715
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
8000015297
FL
Other
Enumeration date
04/03/2012
Last updated
04/03/2012
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