Organization
CHITRA KUTHIALA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHITRA KUTHIALA M.D., PA (PRESIDENT)
(904) 262-9135
Entity
Organization
Contact information
Practice address
9765 SAN JOSE BLVD, SUITE 108, JACKSONVILLE, FL 32257-4402
(904) 262-9135
(904) 880-2948
Mailing address
9765 SAN JOSE BLVD, SUITE 108, JACKSONVILLE, FL 32257-4402
(904) 262-9135
(904) 880-2948
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
ME29708
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192665
WELLCARE
FL
05
—
265658200
—
FL
01
—
2699245
AETNA
FL
01
—
279638
AVMED
FL
01
—
3464796-01
CIGNA
FL
01
—
42736
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/24/2008
Last updated
07/24/2008
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