Provider Demographics
NPI:1770922288
Name:CHOWDHARI, ANTONINA DIJAMCO (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONINA
Middle Name:DIJAMCO
Last Name:CHOWDHARI
Suffix:
Gender:F
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 46518
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33646-0105
Mailing Address - Country:US
Mailing Address - Phone:813-892-8573
Mailing Address - Fax:
Practice Address - Street 1:11707 CLUB DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5521
Practice Address - Country:US
Practice Address - Phone:813-977-2222
Practice Address - Fax:813-434-2373
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69580208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics