Nagaraju, Champaka
Nagaraju, Champaka is an individual health care provider with primary practice located at 1050 Grape Ave , Saint Cloud FL 34769-3965. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Nagaraju, Champaka can be contacted via phone (407) 943-8600.Contact Information
Primary practice address
1050 Grape Ave
Saint Cloud FL 34769-3965
Phone: (407) 943-8600
Fax: (407) 932-5153
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN21014 | Florida |
Profile Details
| NPI number | 1659769891 |
|---|---|
| LBN Legal business name | Nagaraju, Champaka |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2014 |
| Last updated | May 3rd, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659769891 | NPPES |
| Florida | MEDICAID | 110893200 |
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