Provider Demographics
NPI:1306936745
Name:KOTHARI, PRITI M (MD)
Entity type:Individual
Prefix:DR
First Name:PRITI
Middle Name:M
Last Name:KOTHARI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9960 CENTRAL PARK BLVD N
Mailing Address - Street 2:STE. 235
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1759
Mailing Address - Country:US
Mailing Address - Phone:561-483-0844
Mailing Address - Fax:561-483-3342
Practice Address - Street 1:9960 CENTRAL PARK BLVD N
Practice Address - Street 2:STE. 235
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1759
Practice Address - Country:US
Practice Address - Phone:561-483-0844
Practice Address - Fax:561-483-3342
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2009-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME930432084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI25904Medicare UPIN