Individual
BHAVANA SREE VANGARA CHAPMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4753
(904) 388-2619
(904) 388-0240
Mailing address
7015 A C SKINNER PKWY STE 1, JACKSONVILLE, FL 32256-6932
(904) 363-2113
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME148467
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110112800
—
FL
01
—
67I18
FL BLUE
FL
01
—
NR340
MEDICARE
FL
Enumeration date
04/27/2016
Last updated
02/01/2023
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