Provider Demographics
NPI:1407877756
Name:VELISETTY, ASHA (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHA
Middle Name:
Last Name:VELISETTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3309 SW 34TH CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-3311
Mailing Address - Country:US
Mailing Address - Phone:352-342-1414
Mailing Address - Fax:352-237-4931
Practice Address - Street 1:3309 SW 34TH CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-3392
Practice Address - Country:US
Practice Address - Phone:352-237-5118
Practice Address - Fax:352-237-4931
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME463132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD21581Medicare UPIN
FL42192Medicare ID - Type Unspecified