Organization
FLORIDA INTERNAL MEDICINE, PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWARAKNADH R BANALA M.D. (OWNER)
(352) 365-0099
Entity
Organization
Contact information
Practice address
620 S LAKE ST, SUITE# 6, LEESBURG, FL 34748-6059
(352) 365-0099
(352) 315-0578
Mailing address
3016 PALERMO CT, MOUNT DORA, FL 32757-6527
(352) 383-8209
(352) 383-8209
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME80590
FL
Other
Enumeration date
05/29/2006
Last updated
01/10/2011
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