Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 01065255A | IN |
N | 208000000X | Pediatrician | 266641 | NY |
N | 208000000X | Pediatrician | ME116683 | FL |
N | 2080N0001X | Neonatal-Perinatal Doctor | ME116683 | FL |
Y | 2080P0202X | Pediatric Cardiologist | ME116683 | FL |
NPI | 1124311535 |
---|---|
Provider Name | Sukumar Suguna Narasimhulu |
First Address | Gainesville, FL 32610-0296 |
Second Address | Orlando, FL 32806-1215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2011 |
Last Update Date | 31/08/2021 |