P KONDA MD PA
Medical Practice at Southern Blvd, Town Of Loxahatchee Groves, FL

License number
Florida ME43981
Category
Medical Practice
Type
Specialist
Owner
Name: PRASAD KONDA MD
Title: OWNER
Phone: (561) 798-5500
Address
Address
13005 Southern Blvd SUITE 145, Town Of Loxahatchee Groves, FL 33470
National Provider ID: 1376759316
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about P KONDA MD PA at bizstanding.com

P. KONDA, M.D., PA

Town of Loxahatchee Groves, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
P Konda MD PA
Inactive reason:
REINSTATEMENT
Registration:
Sep 16, 1986
Inactive since:
Jan 3, 1996
Phone:
(561) 798-5500 (Phone)
Addresses:
13005 Southern Blvd STE 145, Loxahatchee, FL 33470 (Physical)
13005 Sthern Blvd, Town of Loxahatchee Groves, FL 33470
State ID:
J33405
Business type:
Florida Profit Corporation
Presidents:
Prasad Sr Kondapavuluru (Director), 13005 Southern Blvd STE 145, Loxahatchee, FL 33470 (Physical),Prasad S. Konda (Medical Doctor, Owner),Patrick Mangonon (President)
Agent:
Prasad Kondapavuluru,13005 Palm W, Loxahatchee, FL 33470 (Physical)
EIN:
59-2731946

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