Individual
DR. MAHAPITIYAGE PRITH PEIRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME74689
FL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
ME74689
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME74689
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050075666
RAILROAD MEDICARE
FL
05
—
259580000
—
FL
01
—
35549
BLUECROSS/BLUESHIELD
FL
Enumeration date
10/01/2005
Last updated
12/21/2017
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