Provider Demographics
NPI:1013285048
Name:KELUTH CHAVAN, VENUGOPAL NAIK (MD)
Entity Type:Individual
Prefix:DR
First Name:VENUGOPAL NAIK
Middle Name:
Last Name:KELUTH CHAVAN
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 1:6761 SW 88TH STREET
Mailing Address - Street 2:WATERSIDE APARTMENTS APART D-204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-1767
Mailing Address - Country:US
Mailing Address - Phone:305-903-1344
Mailing Address - Fax:
Practice Address - Street 1:6761 SW 88TH STREET
Practice Address - Street 2:WATERSIDE APARTMENTS APART D-204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-1767
Practice Address - Country:US
Practice Address - Phone:305-903-1344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL161632085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology