Individual
ASHOK K KOMARLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1109 E 139TH AVE, TAMPA, FL 33613-3420
(813) 972-2705
(813) 632-0933
Mailing address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 971-2029
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME54582
FL
2084P0804X
Child & Adolescent Psychiatry Physician
ME54582
FL
2084P0805X
Geriatric Psychiatry Physician
ME54582
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374056100
—
FL
Enumeration date
09/17/2006
Last updated
03/17/2023
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