| Shri Balaji Medical Services | |
|
4123 University Blvd S Suite C Jacksonville FL 32216-4371 | |
| (904) 704-7140 | |
| (866) 683-8679 |
| Full Name | Shri Balaji Medical Services |
|---|---|
| Speciality | Internal Medicine |
| Location | 4123 University Blvd S, Jacksonville, Florida |
| Authorized Official Name and Position | Chitra V Rajpal (PRESIDENT) |
| Authorized Official Contact | 9047047140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shri Balaji Medical Services 4123 University Blvd S Ste C Jacksonville FL 32216-4320 Ph: (904) 704-7140 | Shri Balaji Medical Services 4123 University Blvd S Suite C Jacksonville FL 32216-4371 Ph: (904) 704-7140 |
| NPI Number | 1467799577 |
|---|---|
| Provider Enumeration Date | 01/09/2013 |
| Last Update Date | 07/04/2013 |
| Medicare PECOS PAC ID | 9234376294 |
|---|---|
| Medicare Enrollment ID | O20130510000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467799577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME108505 (Florida) | Primary |
| Provider Name | Chitra Rajpal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376723205 PECOS PAC ID: 2769551126 Enrollment ID: I20111003000641 |
| Provider Name | Yvette Ronisha Lowery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700265618 PECOS PAC ID: 7214242700 Enrollment ID: I20150812008365 |
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