Provider Demographics
NPI:1093098303
Name:BIPAT, ANJALI DEVI (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ANJALI
Middle Name:DEVI
Last Name:BIPAT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534 WHITEWATER FALLS DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4356
Mailing Address - Country:US
Mailing Address - Phone:845-821-0684
Mailing Address - Fax:
Practice Address - Street 1:1534 WHITEWATER FALLS DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-4356
Practice Address - Country:US
Practice Address - Phone:845-821-0684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA47478225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist