| Betsy Cooduvalli, DO | |
|
500 N Washington Ave Ste 109, Titusville, FL 32796 | |
| (321) 768-1600 | |
| Not Available |
| Full Name | Betsy Cooduvalli |
|---|---|
| Gender | Female |
| Speciality | Dermatology |
| Location | 500 N Washington Ave Ste 109, Titusville, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437410230 | NPI | - | NPPES |
| 4583149 | Other | FL | CIGNA |
| 14M7E | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | OS10726 (Florida) | Primary |
| Entity Name | Florida Dermatology Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073577136 PECOS PAC ID: 1557269982 Enrollment ID: O20031223000239 |
| Entity Name | Associates In Dermatology, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316960297 PECOS PAC ID: 1355334863 Enrollment ID: O20040408000108 |
| Entity Name | Aqua Dermatology Of Florida, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538270335 PECOS PAC ID: 1153390414 Enrollment ID: O20041002000097 |
| Entity Name | J Matthew Knight M D P A |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386830263 PECOS PAC ID: 8022191865 Enrollment ID: O20080216000044 |
| Mailing Address | Practice Location Address |
|---|---|
| Betsy Cooduvalli, DO Po Box 690609, Orlando, FL 32869-0609 Ph: (407) 846-7546 | Betsy Cooduvalli, DO 500 N Washington Ave Ste 109, Titusville, FL 32796 Ph: (321) 768-1600 |
Keriea Tia Bean, Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2395 S Washington Ave Ste 1, Titusville, FL 32780 Phone: 321-385-7979 Fax: 321-385-7978 |