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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679780373 NPPES
Louisiana MEDICAID 2339648
Louisiana MEDICAID 06936506

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