Individual
DR. KAMALASANI PANCHAMIRTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1900 27TH ST, VERO BEACH, FL 32960-3383
(772) 794-7400
(772) 794-7453
Mailing address
1900 27TH ST, VERO BEACH, FL 32960-3383
(772) 794-7400
(772) 794-7453
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0069086
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250905900
—
FL
Enumeration date
04/25/2006
Last updated
12/11/2012
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