Organization
V P JEYABARATH MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINAITHEERTHA P JEYABARATH MD (OWNER - PROVIDER)
(352) 754-0500
Entity
Organization
Contact information
Practice address
17222 HOSPITAL BLVD, STE 116, BROOKSVILLE, FL 34601-8925
(352) 754-0500
(352) 754-0515
Mailing address
PO BOX 12399, BROOKSVILLE, FL 34603-2399
(352) 754-0500
(352) 754-0515
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267210300
—
FL
01
—
DO2252
RAILROAD MCR
FL
Enumeration date
02/11/2008
Last updated
01/20/2010
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