Individual
NAGARAKERE R SHANKARAIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3112 S CONGRESS AVE, SUITE A, PALM SPRINGS, FL 33461
(561) 964-0110
(561) 964-0401
Mailing address
3112 S CONGRESS AVE, SUITE A, PALM SPRINGS, FL 33461
(561) 964-0110
(561) 964-0401
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME57808
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064222302
—
FL
05
—
250558400
—
FL
Enumeration date
09/21/2006
Last updated
11/17/2011
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