| Organization Name: | PRASAD KONDA MD PA |
| NPI Number: | 1376759316 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PRASAD KONDA (OWNER) |
| Mailing Address: | 13005 Southern Blvd Suite 145 Loxahatchee |
| State: | FL US |
| Postal Code: | 334709206 |
| Phone Number: | 5617985500 |
| Fax Number: | 5617953341 |
| NPI Enumeration Date: | 05/15/2007 |
| NPI Last Update Date: | 06/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | ME43981 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |