Provider Demographics
NPI:1962513234
Name:CHOKSHI, RAJIV R (MD)
Entity type:Individual
Prefix:
First Name:RAJIV
Middle Name:R
Last Name:CHOKSHI
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 1:4701 N FEDERAL HWY
Mailing Address - Street 2:SUITE A-21
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4608
Mailing Address - Country:US
Mailing Address - Phone:954-771-0611
Mailing Address - Fax:954-491-3930
Practice Address - Street 1:4701 N FEDERAL HWY
Practice Address - Street 2:SUITE A-21
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4608
Practice Address - Country:US
Practice Address - Phone:954-771-0611
Practice Address - Fax:954-491-3930
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLME04679207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD50140Medicare UPIN
FL01434Medicare ID - Type Unspecified