Provider Demographics
NPI:1942372073
Name:DHOLAKIA, SATISHCHANDRA V (MD)
Entity Type:Individual
Prefix:DR
First Name:SATISHCHANDRA
Middle Name:V
Last Name:DHOLAKIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4902 EISENHOWER BLVD.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6344
Mailing Address - Country:US
Mailing Address - Phone:813-636-2000
Mailing Address - Fax:813-321-1877
Practice Address - Street 1:1601 TIMERBLANE DR.
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33567-0957
Practice Address - Country:US
Practice Address - Phone:813-708-1312
Practice Address - Fax:813-321-1877
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101003208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64237555Medicaid
KYA97508Medicare UPIN
KY64237555Medicaid