MEDICARE: PROFESSIONAL PSYCHIATRIC ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1225153612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL PSYCHIATRIC ASSOCIATES

Provider Business Mailing Address
First Line	:	2630 W WATERS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-1835
Country	:	US
Telephone Number	:	813-930-9310
Fax Number	:	813-931-3246

Provider Business Practice Location Address
First Line	:	2630 W WATERS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-1835
Country	:	US
Telephone Number	:	813-930-9310
Fax Number	:	813-931-3246

Authorized Official
Title or Position	:	OWNER PRESIDENT CEO
Name	:	JAYENDRA A CHOKSI
Credential	:	MD
Telephone Number	:	813-930-9310

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	08/22/2020

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