Individual
VIJAYALAKSHMY PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5664 SW 60TH AVENUE, OCALA, FL 34474-5677
(352) 291-5400
(352) 291-5582
Mailing address
3551 RGER BROOKE DR, JBSA FORT SAM HOUSTON, FORT SAM HOUSTON, TX 78234
(210) 539-9567
(210) 539-5467
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME91009
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272180500
—
FL
01
—
50331
BLUE CROSS BLUE SHIELD
FL
01
—
79622
CIGNA BEHAVIORAL HEALTH
—
Enumeration date
05/03/2006
Last updated
04/16/2018
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