Provider Demographics
NPI:1225153612
Name:PROFESSIONAL PSYCHIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:PROFESSIONAL PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAYENDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHOKSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-930-9310
Mailing Address - Street 1:2630 W WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1835
Mailing Address - Country:US
Mailing Address - Phone:813-930-9310
Mailing Address - Fax:813-931-3246
Practice Address - Street 1:2630 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1835
Practice Address - Country:US
Practice Address - Phone:813-930-9310
Practice Address - Fax:813-931-3246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty