Healthcare Provider Details

I. General information

NPI: 1326322801
Provider Name (Legal Business Name): RAJASHREE CHAUDHURY MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2011
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 SW 76TH CT
GAINESVILLE FL
32608-5057
US

IV. Provider business mailing address

7485 SW 17TH RD
GAINESVILLE FL
32607-1000
US

V. Phone/Fax

Practice location:
  • Phone: 706-405-6314
  • Fax:
Mailing address:
  • Phone: 352-333-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number81406
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME138293
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: