Individual
ADITI JALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-3416
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-3416
(904) 244-3415
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
ME156290
FL
2086S0127X
Trauma Surgery Physician
ME156290
FL
Other
Enumeration date
06/06/2017
Last updated
09/07/2023
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