Parabrahma PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PARABRAHMA PA

Doing business as

Center of Excellence in Family and Geriatric Care

Practice address

6100 Greenland Rd Ste 301
Jacksonville, FL 32258-2626

Phone

(904) 337-9494

Fax

(904) 293-1328

NPI assigned

Feb 6, 2019

Organization subpart

No

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

Authorized official

Name

Netrali Patel, MD

Title

President

Phone

(904) 337-9494

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Center of Excellence in Family and Geriatric Care Doing business as

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586995200000",
    "number": "1912462771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 GREENLAND RD STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582626",
            "telephone_number": "904-337-9494",
            "fax_number": "904-293-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 GREENLAND RD STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582626",
            "telephone_number": "904-337-9494",
            "fax_number": "904-293-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARABRAHMA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "NETRALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-337-9494",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102224300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102515400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center of Excellence in Family and Geriatric Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; 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.