Healthcare Provider Details

I. General information

NPI: 1508205279
Provider Name (Legal Business Name): ANAND VIJAY VAKHARIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 02/10/2025
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SW 84 AVE
PLANTAION FL
33324
US

IV. Provider business mailing address

2806 JUNIPER LANE
DAVIE FL
33330
US

V. Phone/Fax

Practice location:
  • Phone: 954-747-7373
  • Fax: 954-741-9074
Mailing address:
  • Phone: 954-243-9737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number302266
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME125784
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: