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General NPI Number Information
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NPI Number | 1508849068
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Entity Type | Individual
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Provider Name | SIRISHA CHALASANI MD
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Gender | Female
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 20021 SW 111TH PL
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City | DUNNELLON
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State | FL
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Zip | 34432-4786
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Country | US
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Telephone | 352-465-1199
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Fax | 352-465-1207
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Provider Business Mailing Address
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Address Line | PO BOX 640573
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City | BEVERLY HILLS
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State | FL
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Zip | 34464-0573
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Country | US
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Telephone | 352-746-1558
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Fax | 352-746-3838
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME10152
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License Number State | FL
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