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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659302891 NPPES
Indiana Other 000000593692 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 200523260 ANTHEM PROVIDER NUMBER

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