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Individual

DR. VIJAYA R CHALAMALASETTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
820 PRUDENTIAL DR STE 304, JACKSONVILLE, FL 32207-8205
(904) 202-3860
(904) 202-3846
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-2092
(904) 376-4075

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME93986
FL
208M00000X
Hospitalist Physician
Primary
ME93986
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0028318-00
FL
05
188342334A
GA
01
P00925338
RR MEDICARE
FL
Enumeration date
05/27/2006
Last updated
04/18/2025
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