Provider Demographics
NPI:1831424142
Name:CHAVDA, KRINA (DO)
Entity type:Individual
Prefix:
First Name:KRINA
Middle Name:
Last Name:CHAVDA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8220 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-6639
Mailing Address - Country:US
Mailing Address - Phone:727-841-8505
Mailing Address - Fax:
Practice Address - Street 1:8220 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6639
Practice Address - Country:US
Practice Address - Phone:727-841-8505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246608-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology