Provider Demographics
NPI:1033164801
Name:BHALWANY, AMIRALI R (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIRALI
Middle Name:R
Last Name:BHALWANY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10051 5TH ST N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2289
Mailing Address - Country:US
Mailing Address - Phone:407-268-9661
Mailing Address - Fax:407-268-9664
Practice Address - Street 1:1718 LEXINGTON GREEN LN
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1018
Practice Address - Country:US
Practice Address - Phone:407-268-9661
Practice Address - Fax:407-268-9664
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2016-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME87290207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01305633OtherRAILROAD MEDICARE
FL267093300Medicaid
FL37598YMedicare PIN