Provider Demographics
NPI:1407231004
Name:CHAUHAN, JITESH (OD)
Entity Type:Individual
Prefix:DR
First Name:JITESH
Middle Name:
Last Name:CHAUHAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3176 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3002
Mailing Address - Country:US
Mailing Address - Phone:954-431-2020
Mailing Address - Fax:
Practice Address - Street 1:3176 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-3002
Practice Address - Country:US
Practice Address - Phone:954-431-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5053152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist