Organization
AKSHAYA BALAJI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVI NAGARAJAN (PRESIDENT)
(407) 360-1742
Entity
Organization
Contact information
Practice address
1900 N ATLANTIC AVE UNIT 1602, DAYTONA BEACH, FL 32118-8312
(407) 285-5956
(321) 339-1949
Mailing address
1900 N ATLANTIC AVE UNIT 1602, DAYTONA BEACH, FL 32118-8312
(407) 285-5956
(321) 339-1949
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
72472
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254154800
—
FL
Enumeration date
04/06/2007
Last updated
11/12/2024
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