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General NPI Number Information
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NPI Number | 1699772574
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Entity Type | Individual
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Provider Name | NANJAPPA CHANDRAMOHAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 2135 SW 19TH AVENUE RD STE 103
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City | OCALA
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State | FL
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Zip | 34471-7877
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Country | US
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Telephone | 352-368-1360
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Fax | 352-237-7728
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Provider Business Mailing Address
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Address Line | PO BOX 2556
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City | OCALA
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State | FL
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Zip | 34478-2556
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Country | US
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Telephone | 352-274-9900
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME84234
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License Number State | FL
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