Healthcare Provider Details

I. General information

NPI: 1689958266
Provider Name (Legal Business Name): PARIMALKUMAR CHAUDHARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

392 RINEHART RD STE 3040
LAKE MARY FL
32746-2548
US

IV. Provider business mailing address

392 RINEHART RD STE 3040
LAKE MARY FL
32746-2548
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-7856
  • Fax: 407-265-2266
Mailing address:
  • Phone: 321-841-7856
  • Fax: 407-265-2266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME140598
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35.129301
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: