M KALAKOTA MD PA
Managed Care Organizations at Central Ave, Kissimmee, FL

License number
Florida ME0061078
Category
Managed Care Organizations
Type
Exclusive Provider Organization
Owner
Name: MADHUSUDANA R KALAKOTA M.D.
Title: PRESIDENT
Phone: (407) 931-2991
Address
Address
1920 N Central Ave, Kissimmee, FL 34741
National Provider ID: 1750520458
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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M. KALAKOTA, M.D., PA

Kissimmee, FL  -  Orlando, FL

Industry:
Real Estate Agent/Manager
Doing business as:
M Kalakota MD Pa
Registration:
Feb 26, 1996
Phone:
(407) 931-2991 (Phone), (407) 931-0025 (Alt)
Addresses:
1920 N Central Ave, Kissimmee, FL 34741 (Physical)
8736 Southern Breeze Dr, Orlando, FL 32836
State ID:
P96000017362
Business type:
Florida Profit Corporation
Presidents:
M Kalakota, 8736 Southern Breeze Dr, Orlando, FL 32836 (Physical),M. Kalakota (President)
Agent:
Kalakota, M,1920 N Central Ave, Kissimmee, FL 34741 (Physical)
EIN:
59-3368006

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