Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | ME107232 | FL |
N | 207RI0011X | Interventional Cardiology | ME107232 | FL |
NPI | 1083623565 |
---|---|
Provider Name | Ashok S Krishnamurthy |
First Address | Orlando, FL 32885-0001 |
Second Address | Bradenton, FL 34210-3217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 06/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003520800 | (05) | FL |
149WK | BCBS (01) | FL |
I26250 | (02) | FL |