Vijayalaxmi Bollu, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME75318 Issued in FL

Practice address

200 SE Hospital Ave
Stuart, FL 34994-2346

Phone

(772) 223-5618

Fax

(772) 288-5834

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1881647667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349950417",
            "telephone_number": "772-223-2832",
            "fax_number": "772-223-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE HOSPITAL AVE",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942346",
            "telephone_number": "772-223-5618",
            "fax_number": "772-288-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLU",
        "first_name": "VIJAYALAXMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME75318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263720100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey Mae Boily
• Jessica Marie Boland
• Neil Carter Boland, MD
• Cami Lea Bolerjack, RBT
• Erica Staci Boley
• Lucia Bonacchi
• Daryl Bonasera, PHARM. D.
• Amanda Ashley Bonavia
• Amy Lynn Bond
• Noah Brantley Bond

• Internal Medicine Physician in Stuart, FL
• Providers in Stuart, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.