Individual
JAYANTHI M RAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9111 WOODBREEZE BLVD, WINDERMERE, FL 34786-8824
(407) 876-1368
Mailing address
9111 WOODBREEZE BLVD, WINDERMERE, FL 34786-8824
(407) 876-1368
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
ME0048846
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07645
BCBS
FL
05
—
372347000
—
FL
Enumeration date
09/13/2005
Last updated
07/15/2010
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