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Individual

MR. PRASAD VRK CHALASANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1900 NEBRASKA AVENUE, SUITE 9, FORT PIERCE, FL 34950-4837
(772) 465-4499
(772) 466-0832
Mailing address
1900 NEBRASKA AVENUE, SUITE 9, FORT PIERCE, FL 34950-4837
(772) 465-4499
(772) 466-0832

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME0072976
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060053466
RAILROAD MEDICARE
01
2071408
AETNA HMO
05
253894600
FL
Enumeration date
09/12/2005
Last updated
07/09/2010
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