Organization
S MANJULA JEGASOTHY MD PA
Active
Organization
S MANJULA JEGASOTHY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEVANTI MANJULA JEGASOTHY MD (OWNER)
(305) 569-0067
Entity
Organization
Contact information
Practice address
135 SAN LORENZO AVE STE 870, CORAL GABLES, FL 33146-1879
(305) 569-0067
(305) 569-0110
Mailing address
135 SAN LORENZO AVE STE 870, CORAL GABLES, FL 33146-1879
(305) 569-0067
(305) 569-0110
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
12/05/2007
Last updated
02/12/2013
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