Organization
WEST COLONIAL URGENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRUJANI GADDAM M.D. (MEDICAL DOCTOR)
(407) 270-5124
Entity
Organization
Contact information
Practice address
4220 W COLONIAL DR, SUITE 3, ORLANDO, FL 32808-8174
(407) 270-5124
(407) 270-5125
Mailing address
4220 W COLONIAL DR, SUITE 3, ORLANDO, FL 32808-8174
(407) 270-5124
(407) 270-5125
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME125820
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME 125820
STATE LICENSE
FL
Enumeration date
12/12/2016
Last updated
12/12/2016
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