Organization
LOUIS J RADNOTHY DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DHARTI BISHT (PRACTICE ADMINISTRATOR)
(352) 669-3175
Entity
Organization
Contact information
Practice address
390 S CENTRAL AVE, UMATILLA, FL 32784-2325
(352) 669-3175
(352) 669-3640
Mailing address
PO BOX 2325, UMATILLA, FL 32784-2325
(352) 669-3175
(352) 669-3640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/27/2006
Last updated
07/03/2023
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