Organization
R KRISHNA MOORTHY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN MAHANY (INSURANCE, BILLING COORDINATOR)
(813) 689-0331
Entity
Organization
Contact information
Practice address
301 E ROBERTSON ST, BRANDON, FL 33511-5253
(813) 689-0331
Mailing address
301 E ROBERTSON ST, BRANDON, FL 33511-5253
(813) 689-0331
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
ME0040574
FL
Other
Enumeration date
02/03/2014
Last updated
02/03/2014
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