Individual provider · NPI-1

Ajith Kumar Potluri, M.D.

Psychiatry & Neurology, Psychiatry · Kissimmee, FL

NPI number1194791392
StatusActive
Last updated in NPPESJun 1, 2022

Details

NPI
1194791392
Entity type
Individual (NPI-1)
Name
Ajith Kumar Potluri
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Feb 27, 2006
Certification date
Jun 1, 2022
Last updated
Jun 1, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084P0800X Psychiatry & Neurology, PsychiatryME115004FLYes
2084P0805X ME115004FL

Practice location

3391 W Vine St Ste 303
Kissimmee, FL 34741-4665

Phone 407-962-7449 · Fax 407-932-0303

Mailing address

3391 W Vine St Ste 303
Kissimmee, FL 34741-4665

Phone 407-962-7449 · Fax 407-932-0303

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