| PK Cherian MD LLC | |
|
758 N Sun Dr Ste 104 Lake Mary FL 32746-2599 | |
| (407) 333-3303 | |
| Not Available |
| Full Name | PK Cherian MD LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 758 N Sun Dr Ste 104, Lake Mary, Florida |
| Authorized Official Name and Position | Pothen C Koruth (PHYSICIAN) |
| Authorized Official Contact | 4078109033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| PK Cherian MD LLC 758 N Sun Dr Ste 104 Lake Mary FL 32746-2599 Ph: (407) 333-3303 | PK Cherian MD LLC 758 N Sun Dr Ste 104 Lake Mary FL 32746-2599 Ph: (407) 333-3303 |
| NPI Number | 1841882669 |
|---|---|
| Provider Enumeration Date | 02/04/2021 |
| Last Update Date | 02/09/2021 |
| Certification Date | 02/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841882669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
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