Healthcare Provider Details

I. General information

NPI: 1790289395
Provider Name (Legal Business Name): JAYASRI DUGGIRALA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 N BELCHER RD STE A3
CLEARWATER FL
33765-1417
US

IV. Provider business mailing address

1831 N BELCHER RD STE A3
CLEARWATER FL
33765-1417
US

V. Phone/Fax

Practice location:
  • Phone: 727-799-9990
  • Fax:
Mailing address:
  • Phone: 727-799-9990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number156801
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME156801
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: