Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 94618 | FL |
Y | 2080P0214X | Pediatric Pulmonologist | ME94618 | FL |
NPI | 1083790570 |
---|---|
Provider Name | Dr. Sreekala Prabhakaran |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 17/09/2010 |