Gorantla, Venkatesan R
Gorantla, Venkatesan R is an individual health care provider with primary practice located at 655 W 8Th St Fl Cc6 , Jacksonville FL 32209-6511. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Gorantla, Venkatesan R can be contacted via phone (513) 310-2392.Contact Information
Primary practice address
655 W 8Th St Fl Cc6
Jacksonville FL 32209-6511
Phone: (513) 310-2392
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | ME102628 | Florida |
Profile Details
NPI number | 1659302891 |
---|---|
LBN Legal business name | Gorantla, Venkatesan R |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 5th, 2006 |
Last updated | Jan 12th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1659302891 | NPPES |
Indiana | Other | 000000593692 | ANTHEM PROVIDER NUMBER |
Indiana | MEDICAID | 200523260 | ANTHEM PROVIDER NUMBER |
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