Individual
KOTESWARI KANCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13241 BARTRAM PARK BLVD UNIT 409, JACKSONVILLE, FL 32258-5237
(904) 400-6800
(904) 400-6801
Mailing address
13241 BARTRAM PARK BLVD UNIT 409, JACKSONVILLE, FL 32258-5237
(904) 400-6800
(904) 400-6801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
98954
FL
207RN0300X
Nephrology Physician
Primary
98954
FL
Other
Enumeration date
10/18/2006
Last updated
12/08/2016
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