MEDICARE: CHIPPY C AJITHAN MD

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
1	207RC0000X	Cardiovascular Disease Physician	ME84450	FL
2	207RC0000X	Cardiovascular Disease Physician	04-51676	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	62695	OTHER		BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598741795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIPPY C AJITHAN MD

Provider Business Mailing Address
First Line	:	1950 ARLINGTON ST STE 400
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-3513
Country	:	US
Telephone Number	:	941-917-4250
Fax Number	:	941-917-4257

Provider Business Practice Location Address
First Line	:	1950 ARLINGTON ST
Second Line	:	STE 400
City	:	SARASOTA
State	:	FL
Zip	:	34239
Country	:	US
Telephone Number	:	941-917-4250
Fax Number	:	941-917-4257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	01/21/2026

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