=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144385337
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SAMER R CHOKSI MD, MPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2006
-----------------------------------------------------
Last Update Date | 11/14/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2221 SW 19TH AVENUE RD UNIT 200
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34471-7758
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-203-4408
-----------------------------------------------------
Fax | 844-602-4616
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2221 SW 19TH AVENUE RD UNIT 200
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34471-7758
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-203-4408
-----------------------------------------------------
Fax | 844-602-4616
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2083X0100X
-----------------------------------------------------
Taxonomy Name | Occupational Medicine Physician
-----------------------------------------------------
License Number | ME96416
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------