Provider Demographics
NPI:1437119054
Name:CHITHRIKI, BABU VEREEN (MD)
Entity Type:Individual
Prefix:
First Name:BABU
Middle Name:VEREEN
Last Name:CHITHRIKI
Suffix:
Gender:M
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:PO BOX 25317
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-5317
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:13241 BARTRAM PARK BLVD UNIT 1509
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5231
Practice Address - Country:US
Practice Address - Phone:904-680-0055
Practice Address - Fax:904-524-8350
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87180207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267634600Medicaid
FL71854ZMedicare PIN
FLH06387Medicare UPIN