Individual
DR. PREMAL SHOBHAN ACHARYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4972 TOWN CENTER PKWY UNIT 301, JACKSONVILLE, FL 32246-8596
(904) 642-6100
(904) 642-5154
Mailing address
3098 BRETTUNGAR DR, JACKSONVILLE, FL 32246-5503
(904) 642-6100
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS11026
FL
208000000X
Pediatrics Physician
UO1626
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101883700
—
FL
Enumeration date
05/30/2007
Last updated
02/15/2019
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