Individual
JYOTI UPADHYAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5153 N 9TH AVE STE 4A, PENSACOLA, FL 32504-8785
(850) 416-1525
(850) 416-1524
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6063
(904) 539-4091
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
ME156724
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02278128
—
NY
01
—
10025466
OPTIMA
VA
05
—
1003985235
—
VA
01
—
311610834
TRICARE
VA
01
—
338953
ANTHEM
VA
05
—
5908034
—
NC
Enumeration date
11/06/2006
Last updated
10/03/2024
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