Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME145397 | FL |
NPI | 1114314705 |
---|---|
Provider Name | Nicholas Talluri |
First Address | Weston, FL 33331-3625 |
Second Address | Sarasota, FL 34232-6028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2015 |
Last Update Date | 28/06/2021 |