Provider Demographics
NPI:1558927970
Name:KAMATH, PREETHA (MD)
Entity Type:Individual
Prefix:
First Name:PREETHA
Middle Name:
Last Name:KAMATH
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:ORANGE PARK MEDICAL CENTER
Mailing Address - Street 2:2001 KINGSLEY AVE
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:904-639-2015
Practice Address - Street 1:ORANGE PARK MEDICAL CENTER
Practice Address - Street 2:2001 KINGSLEY AVE
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073
Practice Address - Country:US
Practice Address - Phone:904-639-2000
Practice Address - Fax:904-639-2015
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program