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General NPI Number Information
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NPI Number | 1265710586
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Entity Type | Individual
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Provider Name | KISHAN NALLAPULA MD.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 13800 TECH CITY CIR STE 320
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City | ALACHUA
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State | FL
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Zip | 32615-7254
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Country | US
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Telephone | 386-853-4835
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Fax | 727-866-4393
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Provider Business Mailing Address
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Address Line | 15113 NW 149TH RD
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City | ALACHUA
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State | FL
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Zip | 32615-0253
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME125648
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 82612
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License Number State | WI
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