Individual
BIJOY PANKAJ TELIVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7015 A C SKINNER PKWY STE 1, JACKSONVILLE, FL 32256-6932
(904) 739-7779
(904) 739-7771
Mailing address
7751 BELFORT PKWY STE 350, JACKSONVILLE, FL 32256-6951
(904) 363-2113
(904) 538-3672
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD432687
PA
207RH0003X
Hematology & Oncology Physician
Primary
ME 106137
FL
207RH0003X
Hematology & Oncology Physician
MT 183359
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002294600
—
FL
05
—
003104112A
—
GA
01
—
243756
FL-BCBS
FL
01
—
337784
AVMED
FL
Enumeration date
09/23/2008
Last updated
02/16/2026
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