Provider Demographics
NPI:1801898986
Name:PPR&D BIOMARKERS INC,
Entity type:Organization
Organization Name:PPR&D BIOMARKERS INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTHAPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MSC, PHD
Authorized Official - Phone:813-866-5692
Mailing Address - Street 1:3802 SPECTRUM BLVD
Mailing Address - Street 2:SUITE 141
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33620-5920
Mailing Address - Country:US
Mailing Address - Phone:813-866-5692
Mailing Address - Fax:
Practice Address - Street 1:3802 SPECTRUM BLVD
Practice Address - Street 2:SUITE 141
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33620-5920
Practice Address - Country:US
Practice Address - Phone:813-866-5692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory