Provider Demographics
NPI:1174807531
Name:JEYAPRAKASH, AYYAMPERUMAL (PH D)
Entity type:Individual
Prefix:DR
First Name:AYYAMPERUMAL
Middle Name:
Last Name:JEYAPRAKASH
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5318 SW 91ST TER
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-8125
Mailing Address - Country:US
Mailing Address - Phone:352-375-5553
Mailing Address - Fax:
Practice Address - Street 1:5318 SW 91ST TER
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-8125
Practice Address - Country:US
Practice Address - Phone:352-375-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QL0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory Management