Provider Demographics
NPI:1194214874
Name:DHAKAL, PRAVASH KUMAR (MD)
Entity type:Individual
Prefix:
First Name:PRAVASH
Middle Name:KUMAR
Last Name:DHAKAL
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 1:17355 EMERALD CHASE DRIVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3516
Mailing Address - Country:US
Mailing Address - Phone:914-314-5093
Mailing Address - Fax:
Practice Address - Street 1:17355 EMERALD CHASE DRIVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3516
Practice Address - Country:US
Practice Address - Phone:914-314-5093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31270101207R00000X
FLME172508207R00000X
PAMD475502207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine