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General NPI Number Information
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NPI Number | 1235327008
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Entity Type | Organization
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Legal Business Name | ADVANCED PRIMARY CARE AND GERIATRICS PA
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 11200 SEMINOLE BLVD STE 210
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City | SEMINOLE
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State | FL
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Zip | 33778-3239
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Country | US
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Telephone | 727-319-8900
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Fax | 727-319-8700
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Provider Business Mailing Address
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Address Line | PO BOX 3925
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City | SEMINOLE
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State | FL
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Zip | 33775-3925
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Country | US
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Telephone | 727-319-8900
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Fax | 727-319-8700
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Authorized Official
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Title or Position | OWNER
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Name | RAMANABABU V PALADUGU
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Credential | M.D.
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Telephone | 727-319-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | ME79071
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License Number State | FL
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