Provider Demographics
NPI:1275650665
Name:KOLLA, MURALI K (MPHARM)
Entity Type:Individual
Prefix:MR
First Name:MURALI
Middle Name:K
Last Name:KOLLA
Suffix:
Gender:M
Credentials:MPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 SW 34TH ST
Mailing Address - Street 2:APT#811
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-8417
Mailing Address - Country:US
Mailing Address - Phone:334-444-4480
Mailing Address - Fax:
Practice Address - Street 1:8441 SW HIGHWAY 200
Practice Address - Street 2:SUITE 131
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-9661
Practice Address - Country:US
Practice Address - Phone:352-854-2464
Practice Address - Fax:352-854-8693
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0041131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist