Mutyala, Srinivas
Mutyala, Srinivas is an individual health care provider with primary practice located at 2625 Executive Park Dr Suite #4, Weston FL 33331-3634. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mutyala, Srinivas can be contacted via phone (954) 659-9051.Contact Information
Primary practice address
2625 Executive Park Dr Suite #4
Weston FL 33331-3634
Phone: (954) 659-9051
Fax: (954) 659-9052
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | ME0076746 | Florida |
Profile Details
| NPI number | 1689654717 |
|---|---|
| LBN Legal business name | Mutyala, Srinivas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 17th, 2006 |
| Last updated | Apr 29th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689654717 | NPPES |
| Florida | MEDICAID | 254938700 |
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