Provider Demographics
NPI:1104894427
Name:JOTHIVIJAYARANI, ARUNACHALAM (MD)
Entity type:Individual
Prefix:
First Name:ARUNACHALAM
Middle Name:
Last Name:JOTHIVIJAYARANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:A.
Other - Middle Name:
Other - Last Name:JOTHIVIJAYARANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4216 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3121
Mailing Address - Country:US
Mailing Address - Phone:941-527-9929
Mailing Address - Fax:941-500-3113
Practice Address - Street 1:4216 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3121
Practice Address - Country:US
Practice Address - Phone:941-500-3100
Practice Address - Fax:941-500-3113
Is Sole Proprietor?:No
Enumeration Date:2006-03-11
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93841207V00000X
FLME93481207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL296991OtherAMERIGROUP
FL306370OtherWELLCARE
FL29211OtherBCBS
FL273149500Medicaid
FL09124OtherUNIVERSAL
FL113522800Medicaid
FL2209708OtherUNITED HEALTHCARE
FL2209708OtherUNITED HEALTHCARE
FLG63973Medicare UPIN
FL273149500Medicaid