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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