Healthcare Provider Details

I. General information

NPI: 1487817722
Provider Name (Legal Business Name): RASHESHKUMAR DHOLAKIA MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

668 MAITLAND AVE
ALTAMONTE SPRINGS FL
32701-6862
US

IV. Provider business mailing address

668 MAITLAND AVE
ALTAMONTE SPRINGS FL
32701-6862
US

V. Phone/Fax

Practice location:
  • Phone: 407-675-3220
  • Fax: 407-675-3216
Mailing address:
  • Phone: 407-675-3220
  • Fax: 407-675-3216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME126619
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: