Individual
PACHAGIRI L SURESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
Mailing address
118 NW COUNTRY LAKE GLN, LAKE CITY, FL 32055-8548
(386) 755-3016
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
50496
FL
Other
Enumeration date
08/30/2006
Last updated
07/26/2007
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