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General NPI Number Information
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NPI Number | 1225569130
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Entity Type | Individual
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Provider Name | KALYAN RAGHAVENDRA CHITTURI D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 13127 VAIL RIDGE DR
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City | RIVERVIEW
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State | FL
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Zip | 33579-7196
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Country | US
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Telephone | 813-661-6199
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Fax | 813-661-6334
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Provider Business Mailing Address
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Address Line | 106 W ARBOR CAMP CIR
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City | SPRING
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State | TX
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Zip | 77389-5323
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Country | US
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Telephone | 740-877-0079
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | V7846
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 77846
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License Number State | TX
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