Provider Demographics
NPI:1790795268
Name:DIGESH CHOKSHI, MD, PA
Entity Type:Organization
Organization Name:DIGESH CHOKSHI, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DIGESH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOKSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-656-4222
Mailing Address - Street 1:1002 S DILLARD ST
Mailing Address - Street 2:SUITE 122
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3991
Mailing Address - Country:US
Mailing Address - Phone:407-656-4222
Mailing Address - Fax:407-656-7117
Practice Address - Street 1:1002 S DILLARD ST
Practice Address - Street 2:SUITE 122
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3991
Practice Address - Country:US
Practice Address - Phone:407-656-4222
Practice Address - Fax:407-656-7117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0071176207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0250762500Medicaid
FL110177944OtherRAIL ROAD
FL232656OtherMEDICARE HMO/WELLCARE
FL31618OtherBCBS
FL232656OtherMEDICARE HMO/WELLCARE
FL0250762500Medicaid