PRAVINCHANDRA ZALA MD PA
Neurology in Brandon, FL

License number
Florida ME0062100
Category
Neurology
Type
Neurology
Owner
Name: MRS. MELISSA MCDONALD
Title: BILLING REP
Phone: (813) 651-3547
Address
Address
500 Vonderburg Dr Ste 314 WEST, Brandon, FL 33511
National Provider ID: 1861792889
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PRAVINCHANDRA ZALA MD PA

500 Vonderburg Dr SUITE 314-W, Brandon, FL 33511

Status:
Inactive
Inactive reason:
REINSTATEMENT
Registration:
Jan 20, 1995
Inactive since:
Mar 28, 2011
State ID:
P95000005827
Business type:
Florida Profit Corporation
President, Director:
Pravinchandra M Zala (President, Director), 500 Vonderburg Dr SUITE 314 W, Brandon, FL 33511 (Physical)
Agent:
Zala, P.c. M,500 Vonderburg Dr SUITE 314 W, Brandon, FL 33511 (Physical)
EIN:
59-3302562

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