Individual
DR. CHAMPAKA NAGARAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1050 GRAPE AVE, SAINT CLOUD, FL 34769-3965
(407) 943-8600
(407) 932-5153
Mailing address
1877 FORTUNE RD, KISSIMMEE, FL 34744-4428
(407) 943-8600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110893200
—
FL
Enumeration date
12/22/2014
Last updated
05/03/2024
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