1194694612 NPI number — SAMARA PRIMARY CARE CLINIC

Table of content: MINAL KEYUR CHAUHAN DPT (NPI 1467540617)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194694612 NPI number — SAMARA PRIMARY CARE CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAMARA PRIMARY CARE CLINIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194694612
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1039 ROCK CREEK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APOPKA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32712-5700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-200-4489
Provider Business Mailing Address Fax Number:
407-554-5860

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2513 SEMORAN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APOPKA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32703-5835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-200-4489
Provider Business Practice Location Address Fax Number:
407-554-5860
Provider Enumeration Date:
11/03/2025

Additional Information

Authorized Official

Authorized Official Last Name:
JOSEPH
Authorized Official First Name:
KIRPICH
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
321-200-4489

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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