Individual
SHASHIKANTH GANGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3001 W DR MARTIN LUTHER KING JR BLVD FL 1, TAMPA, FL 33607-6307
(813) 357-0711
Mailing address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 240-5893
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
ME131651
FL
Other
Enumeration date
05/26/2014
Last updated
05/01/2019
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