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Individual

DR. AMIT K CHAKRAVARTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8075 GATE PKWY W, SUITE 304, JACKSONVILLE, FL 32216-3684
(904) 739-6666
(904) 739-1009
Mailing address
PO BOX 56917, JACKSONVILLE, FL 32241-6917
(904) 739-6666
(904) 739-1009

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME0053176
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
254907700
FL
01
290011203
RR MEDICARE
FL
01
44730
BCBSFL
FL
01
P00367696
RAIL ROAD MEDICARE
FL
Enumeration date
07/06/2006
Last updated
08/07/2008
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