MEDICARE: JAYASRI DUGGIRALA MD

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
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	156801	FL
2	207R00000X	Internal Medicine Physician	ME156801	FL

General Provider Information

NPI Number	:	1790289395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYASRI DUGGIRALA MD

Provider Business Mailing Address
First Line	:	1831 N BELCHER RD STE A3
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33765-1417
Country	:	US
Telephone Number	:	727-799-9990
Fax Number	:

Provider Business Practice Location Address
First Line	:	1831 N BELCHER RD STE A3
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33765-1417
Country	:	US
Telephone Number	:	727-799-9990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2018
Last Update Date	:	06/24/2025

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