Individual
DR. KOLLAGUNTA SREENIVASA CHANDRASEKHAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
320 1ST ST N, WINTER HAVEN, FL 33881-4113
(863) 508-1101
(863) 299-6158
Mailing address
320 1ST ST N, WINTER HAVEN, FL 33881-4113
(863) 508-1101
(863) 299-6158
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME64020
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18806
BC BS
FL
05
—
372983400
—
FL
Enumeration date
03/14/2006
Last updated
01/17/2017
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