Individual
MR. NILUKSHAN RANIL SIRIGAMPOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
25 W CRYSTAL LAKE ST, ORLANDO, FL 32806-4475
(407) 254-2500
Mailing address
25 W CRYSTAL LAKE ST, ORLANDO, FL 32806-4475
(407) 254-2500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9114956
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9114956
FL
Other
Enumeration date
06/07/2015
Last updated
11/29/2023
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