Provider Demographics
NPI:1659475705
Name:PAREKH, KISHORCHANDRA J (MD)
Entity Type:Individual
Prefix:DR
First Name:KISHORCHANDRA
Middle Name:J
Last Name:PAREKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 ROSALIA CT
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-5405
Mailing Address - Country:US
Mailing Address - Phone:772-785-9120
Mailing Address - Fax:
Practice Address - Street 1:134 ROSALIA CT
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33478-5405
Practice Address - Country:US
Practice Address - Phone:772-785-9120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME436672085R0202X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069653600Medicaid
FLD65278Medicare UPIN
FL61407Medicare PIN