Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Srinivasa Rao Komirisetty

Individual provider Pharmacist · NPI 1164700605

Srinivasa Rao Komirisetty is a Pharmacist in Jacksonville, Florida. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2011
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Practice location Address checks out

10010 Belle Rive Blvd Apt 510
Jacksonville, FL 32256-9519
Phone: (409) 782-2402
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 055526-1 (NY)

Record details

NPI number1164700605
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 2, 2011
Last updated in NPPESAugust 2, 2011

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