Provider Demographics
NPI:1073715819
Name:ASHOK KUMAR DHADUVAI MD PA
Entity Type:Organization
Organization Name:ASHOK KUMAR DHADUVAI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHOK KUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:DHADUVAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-729-6818
Mailing Address - Street 1:2901 US HIGHWAY 301 N
Mailing Address - Street 2:
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-2007
Mailing Address - Country:US
Mailing Address - Phone:941-729-6818
Mailing Address - Fax:941-723-9449
Practice Address - Street 1:2901 US HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:ELLENTON
Practice Address - State:FL
Practice Address - Zip Code:34222-2007
Practice Address - Country:US
Practice Address - Phone:941-729-6818
Practice Address - Fax:941-723-9449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064266207R00000X
FLME0060506207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057742100Medicaid
FL057742100Medicaid