ANANDAVALLI - KRISHNAMOORTHY , MD in LAKELAND - NPI - 1205821287
ANANDAVALLI KRISHNAMOORTHY is a dentist based out of AVON PARK,Florida ANANDAVALLI practices in LAKELAND,Florida and has the professional credentials of MD .The NPI Number for ANANDAVALLI KRISHNAMOORTHY is 1205821287 and he holds a Licence No. ME79252(Florida).
ANANDAVALLI current practice location address is 950 COUNTY ROAD 17A W,,AVON PARK,Florida and he can be reached out via phone at 8634138600 and via fax at8634138650. You can also correspond with ANANDAVALLI KRISHNAMOORTHY through mail at his mailing address at936 E PARKER ST,,LAKELAND,Florida – 338011968 (mailing address contact number – 338252164).
Provider Profile Details
| NPI Number | 1205821287 |
| Provider Name | ANANDAVALLI KRISHNAMOORTHY |
| MD | |
| Gender | 39589 |
| Provider Entity Type | Individual |
| Provider Enumeration Date | 207P00000X |
| Last Update Date | 38610 |
Provider Business Mailing Address Details
| Address | 950 COUNTY ROAD 17A W, |
| City | AVON PARK |
| State | Florida |
| Zip | 338252164 |
| Phone Number | 8634523060 |
Provider Business Practice Location Address Details
| Address | 936 E PARKER ST, |
| City | LAKELAND |
| State | Florida |
| Zip | 338011968 |
| Phone Number | 8634138600 |
Provider's Primary Taxonomy Details
| Taxonomy | 207P00000X |
| License No. | ME79252 |
| State | Florida |