Individual
DR. REVATHI IYENGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 E DIXIE AVE, LEESBURG, FL 34748-5925
(352) 323-5467
(352) 315-3633
Mailing address
PO BOX 100236, GAINESVILLE, FL 32610-0236
(352) 273-5550
(352) 273-5575
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME113806
FL
2084N0600X
Clinical Neurophysiology Physician
ME113806
FL
Other
Enumeration date
09/05/2008
Last updated
02/10/2022
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