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General NPI Number Information
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NPI Number | 1093799298
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Entity Type | Individual
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Provider Name | VASUDEVAN ANJORE KIDAMBI M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 10/20/2008
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Provider Practice Location Address
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Address Line | 3200 SW 34TH AVE SUITE 302
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City | OCALA
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State | FL
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Zip | 34474-7456
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Country | US
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Telephone | 352-732-2900
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Fax | 352-732-4430
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Provider Business Mailing Address
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Address Line | 3200 SW 34TH AVE SUITE 302
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City | OCALA
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State | FL
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Zip | 34474-7456
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Country | US
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Telephone | 352-732-2900
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Fax | 352-732-4430
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME0068971
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License Number State | FL
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