Individual
DR. GEETHA PRIYANKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
948 S WICKHAM RD, SUITE 103, WEST MELBOURNE, FL 32904-1647
(321) 956-7370
(321) 956-7873
Mailing address
948 S WICKHAM RD, SUITE 103, WEST MELBOURNE, FL 32904-1647
(321) 956-7370
(321) 956-7873
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME78873
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257471300
—
FL
01
—
49252
BCBS
FL
Enumeration date
11/14/2006
Last updated
07/15/2015
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