Individual
DR. SANGY PAUL POTTACKAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, MDC 41, TAMPA, FL 33612-4742
(813) 974-3680
Mailing address
2700 UNIVERSITY SQUARE DR, TAMPA, FL 33612-5513
(813) 253-2721
(813) 977-3720
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME127595
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2011
Last updated
05/12/2017
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