Individual
RAVI PRASAD AVATI NANJUNDAPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
1658 ST VINCENTS WAY STE 300, MIDDLEBURG, FL 32068
(904) 276-5100
(904) 276-5393
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 296-5691
(904) 450-6401
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
61823
GA
207RC0000X
Cardiovascular Disease Physician
MD.206105
LA
207RC0000X
Cardiovascular Disease Physician
Primary
ME135622
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06936506
—
MS
05
—
2339648
—
LA
Enumeration date
05/16/2007
Last updated
08/17/2018
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