Organization
KETAMINE WELLNESS INSTITUTE OF JACKSONVILLE BEACH, LLC
Active
Organization
KETAMINE WELLNESS INSTITUTE OF JACKSONVILLE BEACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SATHAVARAM REDDY MD (OWNER)
(904) 373-8153
Entity
Organization
Contact information
Practice address
1361 13TH AVE S STE 140, JACKSONVILLE BEACH, FL 32250-3263
(904) 373-8153
Mailing address
1361 13TH AVE S STE 140, JACKSONVILLE BEACH, FL 32250-3263
(904) 373-8153
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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