Individual
DR. PAUL DAVID JAYACHANDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M D P A
Contact information
Practice address
1680 OSCEOLA ELEMENTARY RD, STE A, ST AUGUSTINE, FL 32084-0968
(904) 824-7476
(904) 824-7870
Mailing address
1680 OSCEOLA ELEMENTARY RD, STE A, ST AUGUSTINE, FL 32084-0968
(904) 824-7476
(904) 824-7870
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME0066989
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150095
HEALTHEASE
FL
01
—
206068
AVMED
FL
01
—
26220
BCBS FLORIDA
FL
01
—
26220Y
MEDICARE
FL
05
—
376531800
—
FL
05
—
376531801
—
FL
01
—
5777008
AETNA
FL
01
—
AA919
MEDICARE PTAN
FL
Enumeration date
06/28/2005
Last updated
02/18/2016
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