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Individual

KRISHNA D THIRUMALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3599 UNIVERSITY BLVD S, BUILDING 300, JACKSONVILLE, FL 32216-4252
(904) 399-5550
(904) 346-4334
Mailing address
3599 UNIVERSITY BLVD S, BUILDING 300, JACKSONVILLE, FL 32216-4252
(904) 399-5550
(904) 346-4334

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C182807
CA
2085R0202X
Diagnostic Radiology Physician
ME97416
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
277749500
FL
05
519719105A
GA
01
92886
BCBS
FL
01
P00434974
RAILROAD MEDICARE
GA
Enumeration date
02/12/2007
Last updated
06/24/2024
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