Avati Nanjundappa, Ravi Prasad
Avati Nanjundappa, Ravi Prasad is an individual health care provider with primary practice located at 1658 St Vincents Way Ste 300 , Middleburg FL 32068. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Avati Nanjundappa, Ravi Prasad can be contacted via phone (904) 276-5100.Contact Information
Primary practice address
1658 St Vincents Way Ste 300
Middleburg FL 32068
Phone: (904) 276-5100
Fax: (904) 276-5393
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 61823 | Georgia |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MD.206105 | Louisiana |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | ME135622 | Florida |
Profile Details
| NPI number | 1679780373 |
|---|---|
| LBN Legal business name | Avati Nanjundappa, Ravi Prasad |
| Credentials | MD, MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2007 |
| Last updated | Aug 17th, 2018 - about 6 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 | 1679780373 | NPPES |
| Louisiana | MEDICAID | 2339648 | |
| Louisiana | MEDICAID | 06936506 |
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