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NPI Code Detail

MEDICARE: SAILAJA RAVILLA APRN, FNP-C

MEDICARE: SAILAJA RAVILLA APRN, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN11015456FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326601501
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAILAJA RAVILLA APRN, FNP-C
Provider Business Mailing Address
First Line : 120 SAINT JOHNS COMMONS RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32259-4057
Country : US
Telephone Number : 904-824-9177
Fax Number :
Provider Business Practice Location Address
First Line : 120 SAINT JOHNS COMMONS RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32259-4057
Country : US
Telephone Number : 904-824-9177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2019
Last Update Date : 07/22/2025

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