Individual
DR. MALLESWARI S RAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
653-1 WEST 8TH STREET, 2ND FLOOR, LRC L14, JACKSONVILLE, FL 32209
(904) 244-3702
Mailing address
PO BOX 44008, SUITE 304, JACKSONVILLE, FL 32231-4008
(904) 244-2120
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME104972
FL
207RI0200X
Infectious Disease Physician
Primary
ME104972
FL
208M00000X
Hospitalist Physician
ME104972
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0037280-00
—
FL
05
—
373978308
—
FL
Enumeration date
07/02/2007
Last updated
12/20/2020
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