Provider Demographics
NPI:1174587687
Name:BOYAPATI, KRANTHI (MD)
Entity type:Individual
Prefix:
First Name:KRANTHI
Middle Name:
Last Name:BOYAPATI
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 1:3300 SW 34TH AVE
Mailing Address - Street 2:SUITE 124A
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7448
Mailing Address - Country:US
Mailing Address - Phone:352-315-7800
Mailing Address - Fax:352-360-6582
Practice Address - Street 1:2020 TALLEY RD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-3426
Practice Address - Country:US
Practice Address - Phone:352-315-7800
Practice Address - Fax:352-360-6582
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 862192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL37325OtherBLUE CROSS BLUE SHIELD #
BB7379236OtherDEA #
FL37325AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
FL37325OtherBLUE CROSS BLUE SHIELD #