Provider Demographics
NPI:1154421766
Name:CHOKSI, TARAK SUMAN (MD)
Entity type:Individual
Prefix:
First Name:TARAK
Middle Name:SUMAN
Last Name:CHOKSI
Suffix:
Gender:
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:PO BOX 850001, DEPT 8340
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0001
Mailing Address - Country:US
Mailing Address - Phone:813-536-7277
Mailing Address - Fax:855-830-1722
Practice Address - Street 1:1838 HEALTH CARE DR UNIT 2
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5362
Practice Address - Country:US
Practice Address - Phone:813-909-1146
Practice Address - Fax:813-909-4334
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90489207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272816800Medicaid
FLH66400Medicare UPIN
FL16037ZMedicare PIN