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NPI Code Detail

MEDICARE: AKHIL KOLLURI

MEDICARE: AKHIL KOLLURI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
22085R0202XDiagnostic Radiology PhysicianME173387FL

General Provider Information

NPI Number : 1255969903
Entity Type Code : Individual
Provider Name (Legal Business Name) : AKHIL KOLLURI
Provider Business Mailing Address
First Line : PO BOX 100374
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-0374
Country : US
Telephone Number : 352-265-0438
Fax Number : 352-265-0592
Provider Business Practice Location Address
First Line : 1600 SW ARCHER RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-3003
Country : US
Telephone Number : 352-265-0438
Fax Number : 352-265-0592
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2020
Last Update Date : 05/28/2026

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