Individual
KOUSALYA SARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2700 HEALING WAY STE 303, WESLEY CHAPEL, FL 33543-5471
(813) 929-5380
(813) 929-5991
Mailing address
2700 HEALING WAY STE 303, WESLEY CHAPEL, FL 33543-5471
(813) 929-5380
(813) 929-5991
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
60230
GA
208000000X
Pediatrics Physician
Primary
ME99943
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60230
GA MEDICAL LICENSE
GA
01
—
ME99943
FLORIDA BOARD OF MEDICINE
FL
Enumeration date
08/16/2007
Last updated
06/03/2020
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