Individual
DR. CHITRA KUTHIALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9765 SAN JOSE BLVD, JACKSONVILLE, FL 32257-4402
(904) 262-9135
Mailing address
9765 SAN JOSE BLVD, JACKSONVILLE, FL 32257-4402
(904) 262-9135
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
021322
GA
207K00000X
Allergy & Immunology Physician
Primary
29708
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192665
HEALTHEASE
FL
05
—
265658200
—
FL
01
—
2699245
AETNA
FL
01
—
279638
AVMED
FL
01
—
3464796-01
CIGNA
FL
01
—
42736
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/12/2006
Last updated
07/09/2007
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