Individual
JYOTISHANKAR RAYCHAUDHURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBBS
Contact information
Practice address
801 N FLAMINGO RD STE 11, PEMBROKE PINES, FL 33028
(954) 265-4325
(954) 443-4747
Mailing address
2900 CORPORATE WAY, DOOR D, MIRAMAR, FL 33025-3925
(954) 276-5685
(954) 985-7074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME74327
FL
207RH0000X
Hematology (Internal Medicine) Physician
Primary
ME74327
FL
207RX0202X
Medical Oncology Physician
ME74327
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276000200
—
FL
01
—
56279
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/15/2006
Last updated
08/18/2018
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