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General NPI Number Information
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NPI Number | 1255523551
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Entity Type | Individual
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Provider Name | CHAYAPATHY JOLLU MD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 10238 SW 86TH CIR UNIT 300
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City | OCALA
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State | FL
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Zip | 34481-7625
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Country | US
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Telephone | 352-873-1011
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Fax | 352-873-1017
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Provider Business Mailing Address
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Address Line | 10238 SW 86TH CIR UNIT 300
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City | OCALA
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State | FL
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Zip | 34481-7625
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Country | US
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Telephone | 352-873-1011
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Fax | 352-873-1017
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 26157
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 4301090436
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | ME99148
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License Number State | FL
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