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Individual

DR. VASU NAGARAJU LAKKIMSETTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.,

Contact information

Practice address
619 S MARION AVE, ROUTING # 11 FA, LAKE CITY, FL 32025-5808
(386) 755-3016
Mailing address
619 S MARION AVE, ROUTING # 11 FA, LAKE CITY, FL 32025-5808
(386) 755-3016

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
ME103433
FL
390200000X
Student in an Organized Health Care Education/Training Program
12871
FL

Other

Enumeration date
01/09/2009
Last updated
10/28/2010
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