Provider Demographics
NPI:1760559785
Name:YELAMANCHI, NALINI A (MD)
Entity Type:Individual
Prefix:
First Name:NALINI
Middle Name:A
Last Name:YELAMANCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NALINI
Other - Middle Name:AVULA
Other - Last Name:YELAMANCHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:11834 COUNTY ROAD 101 STE 203
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-9340
Mailing Address - Country:US
Mailing Address - Phone:352-391-5900
Mailing Address - Fax:
Practice Address - Street 1:11834 COUNTY ROAD 101 STE 203
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-9340
Practice Address - Country:US
Practice Address - Phone:352-391-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81890207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269089600Medicaid
FL376214WMedicare ID - Type Unspecified
FLI042248Medicare UPIN