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General NPI Number Information
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NPI Number | 1992198501
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Entity Type | Organization
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Legal Business Name | KRISHNA KASTURI, MD, LLC
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Dates
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Enumeration Date | 03/07/2015
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Last Update Date | 07/05/2015
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Provider Practice Location Address
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Address Line | 10502 SPRING HILL DR
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City | SPRING HILL
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State | FL
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Zip | 34608-5046
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Country | US
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Telephone | 352-277-0966
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Fax | 352-282-3969
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Provider Business Mailing Address
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Address Line | 10502 SPRING HILL DR
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City | SPRING HILL
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State | FL
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Zip | 34608-5046
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Country | US
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Telephone | 352-277-0966
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. KRISHNA SAGAR KASTURI
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Credential | M.D
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Telephone | 352-277-0966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME112279
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License Number State | FL
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