| Doctor Name: | DR. MADHAVA T PALLY |
| NPI Number: | 1821005422 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., P.A. |
| License Number: | ME42506 |
| Business Practice Address: | 228 Plaza Dr Lehigh Acres, FL - 339366054 |
| Business Phone Number: | 2393039550 |
| Business Fax Number: | 2393039551 |
| Mailing Address: | 2316 Patrinostro Rd, PLANT CITY |
| State: | FL |
| Postal Code: | 335657228 |
| Phone Number: | 8882460313 |
| Fax Number: | 8882471186 |
| NPI Enumeration Date: | 08/03/2006 |
| NPI Last Update Date: | 12/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | ME42506 |
| 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. |