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NPI Code Detail

MEDICARE: DR. PRADYUMANSINH M CHUDASAMA MD

MEDICARE: DR. PRADYUMANSINH M CHUDASAMA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME66912FL

General Provider Information

NPI Number : 1306827027
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRADYUMANSINH M CHUDASAMA MD
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3691 CLYDE MORRIS BLVD
Second Line :
City : PORT ORANGE
State : FL
Zip : 32129-2317
Country : US
Telephone Number : 386-675-4411
Fax Number : 866-542-5859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 02/17/2026

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Directions to “ DR. PRADYUMANSINH M CHUDASAMA MD” Practice Location

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