Organization
KV SUNDARESH MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KORAVANGALA V SUNDARESH M.D. (OWNER)
(727) 457-5522
Entity
Organization
Contact information
Practice address
5810 STATE ROAD 54, NEW PORT RICHEY, FL 34652-6050
(727) 845-3890
Mailing address
5810 STATE ROAD 54, NEW PORT RICHEY, FL 34652-6050
(727) 845-3890
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME0042812
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069547500
—
FL
Enumeration date
02/09/2015
Last updated
02/09/2015
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