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Individual

GAMINI S SOORIYAARACHCHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1708 CAPE CORAL PKWY W STE 10, CAPE CORAL, FL 33914-6985
(239) 541-4633
(239) 541-1825
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200

Taxonomy

Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME98442
FL
207RH0003X
Hematology & Oncology Physician
ME98442
FL
207RX0202X
Medical Oncology Physician
Primary
ME98442
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023137600
FL
Enumeration date
01/18/2006
Last updated
09/02/2022
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