Provider Demographics
NPI:1508205279
Name:VAKHARIA, ANAND VIJAY (MD)
Entity type:Individual
Prefix:
First Name:ANAND
Middle Name:VIJAY
Last Name:VAKHARIA
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 1:2806 JUNIPER LANE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330
Mailing Address - Country:US
Mailing Address - Phone:954-243-9737
Mailing Address - Fax:
Practice Address - Street 1:201 SW 84 AVE
Practice Address - Street 2:
Practice Address - City:PLANTAION
Practice Address - State:FL
Practice Address - Zip Code:33324
Practice Address - Country:US
Practice Address - Phone:954-747-7373
Practice Address - Fax:954-741-9074
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302266207Q00000X
FLME125784207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty