Individual
DR. GOPAL CHALAVARYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7614 JACQUE RD, STE C, HUDSON, FL 34667-7195
(727) 862-8383
(727) 863-4766
Mailing address
PO BOX 7386, HUDSON, FL 34674-7386
(727) 862-8383
(727) 863-4766
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME53574
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00902
UNIVERSAL
FL
01
—
060063820
RRW MCR
—
01
—
14899
BCBS
FL
01
—
185990
WELLCARE
FL
01
—
204168
AVMED
—
05
—
371068800
—
FL
Enumeration date
09/15/2005
Last updated
03/09/2010
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