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Individual

DR. MUTTATHIL P RAVINDRANATHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
14540 CORTEZ BLVD, SUITE 119, BROOKSVILLE, FL 34613-6056
(352) 597-3353
(352) 597-3368
Mailing address
14540 CORTEZ BLVD, SUITE 119, BROOKSVILLE, FL 34613-6056
(352) 597-3353
(352) 597-3368

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0027078
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
065827800
FL
Enumeration date
02/22/2006
Last updated
10/19/2009
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