Provider Demographics
NPI:1639331176
Name:ACHARYA, VIRAL (MD)
Entity Type:Individual
Prefix:
First Name:VIRAL
Middle Name:
Last Name:ACHARYA
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 1:1 SHIRCLIFF WAY STE 1223
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4748
Mailing Address - Country:US
Mailing Address - Phone:904-900-2421
Mailing Address - Fax:904-308-3960
Practice Address - Street 1:1200 RIVERPLACE BLVD
Practice Address - Street 2:SUITE 620
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-9046
Practice Address - Country:US
Practice Address - Phone:904-396-6650
Practice Address - Fax:904-396-6528
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102006207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME102006OtherFLORIDA LICENSE
FL000326500Medicaid