DR. CHETHAN KRISHNA RAO (NPI# 1720519713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720519713 |
| Entity Type | Individual |
| Full Name | DR. CHETHAN KRISHNA RAO |
| Credential | D.O. |
| Practice Address |
841 Prudential Dr Suite 1130 Jacksonville FL 32207-8329 |
| Practice Telephone | 9046334199 |
| Practice Fax Number | 9046334188 |
| Mailing Telephone | 9046334199 |
| Mailing Fax Number | 9046334188 |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2020-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
UO5490 | FL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4500 San Pablo Rd S, Jacksonville, FL 322241865 | 9049532000 |
| Street Address |
841 PRUDENTIAL DR SUITE 1130 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962403949 | Katherine Elizabeth Stenberg Curry | Physician Assistant | 841 Prudential Dr, Ufjax - Pediatric Cardiothoracic Surgery, Jacksonville, FL 32207-8329 | 2005-08-02 |
| 1780213157 | Emergency Physicians Inc | Emergency Medicine | 841 Prudential Dr, Jacksonville, FL 32207-8329 | 2020-04-07 |
| 1083176887 | Katherine Margaritis | Dietitian, Registered | 841 Prudential Dr, Jacksonville, FL 32207-8329 | 2019-04-02 |
| 1063971356 | Dillon Oberlin Snyder | Student in an Organized Health Care Education/Training Program | 841 Prudential Dr, Jacksonville, FL 32207-8329 | 2019-03-15 |
| 1295234086 | Shacara Mitchell | Counselor | 841 Prudential Dr, Jacksonville, FL 32207-8329 | 2018-02-07 |
| 1922539444 | Colleen Timmons | Student in an Organized Health Care Education/Training Program | 841 Prudential Dr, Suite 1130, Jacksonville, FL 32207-8329 | 2017-03-26 |
| 1578007118 | Nicole Winter | Psychologist | 841 Prudential Dr, Suite 180, Jacksonville, FL 32207-8329 | 2016-12-16 |
| 1912455981 | Meredith Shippey | Nurse Practitioner | 841 Prudential Dr, 10th Floor, Jacksonville, FL 32207 | 2016-09-19 |
| 1205298635 | Natalie Alexis Booth | Student in an Organized Health Care Education/Training Program | 841 Prudential Dr, Suite 1130, Jacksonville, FL 32207-8329 | 2016-03-24 |
| 1134581895 | Rebecca Ward | Pediatrics | 841 Prudential Dr, Suite 1130, Jacksonville, FL 32207-8329 | 2016-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336792829 | Graciela Teresita Gallo | Psychiatry & Neurology | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2019-07-23 |
| 1407241961 | Dana Shprung | Psychiatry & Neurology | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2015-04-01 |
| 1225444664 | Jun Ho Kim | Psychiatry & Neurology | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2014-07-07 |
| 1720401151 | Neuro Care, Pllc | Psychiatry & Neurology | 3050 Henderson Dr, Jacksonville, NC 28540 | 2014-01-21 |
| 1992962773 | Erick Viorritto | Psychiatry & Neurology | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2008-05-20 |
| 1861682940 | Rubina Y Bakerywala | Psychiatry & Neurology | 807 Childrens Way, Provider Enrollment Department, Jacksonville, FL 32207-8426 | 2007-07-26 |
| 1699786129 | David N. Hammond | Psychiatry & Neurology | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2006-08-10 |
| 1427069947 | Harry S. Abram Jr. | Psychiatry & Neurology | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2006-08-10 |
| 1790706711 | Carmela Lydia Tardo | Psychiatry & Neurology | 6271 Saint Augustine Rd, Ufjp Developmental Pediatrics, Jacksonville, FL 32217-2523 | 2006-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841724861 | Neuro and Epilepsy Care Inc | Psychiatry & Neurology | 331 N Maitland Ave Ste D3, Maitland, FL 32751-4755 | 2017-04-17 |
| 1407201510 | Robert Kropp | Psychiatry & Neurology | 100 Beach Dr Ne Unit 1702, Saint Petersburg, FL 33701-3969 | 2016-04-26 |
| 1497142178 | Gian Carlo Rossi | Psychiatry & Neurology | 1324 Lakeland Hills Blvd Ste A, Lakeland, FL 33805-4543 | 2015-04-21 |
| 1851638167 | Ernesto J. Millan Md. Pa. | Psychiatry & Neurology | 5110 N. Habana Ave. Suite #1, Tampa, FL 33614-6873 | 2013-01-07 |
| 1942557863 | Henry Osso-rivera | Psychiatry & Neurology | 3100 Sw 62nd Ave Ofc, Miami, FL 33155-3009 | 2012-08-09 |
| 1235492679 | Clermont Neurology,pa | Psychiatry & Neurology | 17307 Pagonia Dr., Suite 100, Clermont, FL 34711-5932 | 2012-06-20 |
| 1093073645 | Abigail E Ley | Psychiatry & Neurology | 150 Sw Chamber Ct Ste 120, Port Saint Lucie, FL 34986 | 2012-05-01 |
| 1033351317 | Danilo Augusto Duenas | Psychiatry & Neurology | 9900 S. Ocean Dr., (601), Jensen Beach, FL 34957 | 2009-04-01 |
| 1619125622 | Avi Elizabeth Domnitz-gebet | Psychiatry & Neurology | 5129 S Lakeland Dr Ste 2, Lakeland, FL 33813-2599 | 2008-09-03 |
| 1508021742 | Germano Falcao | Psychiatry & Neurology | 2984 Alafaya Trl Ste 2020, Oviedo, FL 32765-7628 | 2008-07-28 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on DR. CHETHAN KRISHNA RAO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.