Provider Demographics
NPI:1134187164
Name:UPPU, VIJAYA LAKSHMI (MD)
Entity type:Individual
Prefix:DR
First Name:VIJAYA
Middle Name:LAKSHMI
Last Name:UPPU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1607 SAINT JAMES CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5352
Mailing Address - Country:US
Mailing Address - Phone:850-878-0191
Mailing Address - Fax:850-521-5701
Practice Address - Street 1:1615 MAHAN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5443
Practice Address - Country:US
Practice Address - Phone:850-521-5700
Practice Address - Fax:850-521-5701
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME696042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry