Individual
ADWAIT H JATHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MICHIGAN AVE, MELBOURNE, FL 32901-3100
(321) 952-0700
(321) 952-4444
Mailing address
200 MICHIGAN AVE, MELBOURNE, FL 32901-3100
(321) 952-0700
(321) 952-4444
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME96379
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1378963
AETNA
FL
05
—
276213700
—
FL
01
—
2769681002
CIGNA
FL
01
—
293711
WELLCARE
FL
01
—
56422
BLUE CROSS BLUE SHIELD
FL
01
—
7863816
AETNA
FL
Enumeration date
02/01/2006
Last updated
11/10/2015
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