Organization
PAUL D JAYACHANDRA M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDER RICHIEZ (OFFICE MANAGER)
(305) 807-8807
Entity
Organization
Contact information
Practice address
1851 OLD MOULTRIE RD STE A, ST AUGUSTINE, FL 32084-4167
(904) 824-7476
(904) 824-7870
Mailing address
1851 OLD MOULTRIE RD STE A, ST AUGUSTINE, FL 32084-4167
(904) 824-7476
(904) 824-7870
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0066989
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110132302
UNITED HEALTHCARE
FL
01
—
150095
WELLCARE
FL
01
—
206068
AVMED
FL
01
—
26220
BCBS FLORIDA
FL
01
—
26220Y
MEDICARE PROVIDER NUMBER
FL
05
—
376531800
—
FL
05
—
376531801
—
FL
01
—
390006717
RAILROAD MEDICARE
FL
01
—
5777008
AETNA
FL
01
—
94163841
WAUSA BENIFITS
FL
01
—
AA919
MEDICARE PTAN
FL
Enumeration date
02/21/2007
Last updated
04/21/2026
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