Provider Demographics
NPI:1235620519
Name:BALDEV, KHUSHBOO (MD)
Entity Type:Individual
Prefix:DR
First Name:KHUSHBOO
Middle Name:
Last Name:BALDEV
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 223190
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33022-3190
Mailing Address - Country:US
Mailing Address - Phone:305-974-5533
Mailing Address - Fax:305-974-5553
Practice Address - Street 1:240 W INDIANTOWN RD STE 107
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3548
Practice Address - Country:US
Practice Address - Phone:305-974-5533
Practice Address - Fax:305-974-5553
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11378300207L00000X
CT390200000X
FLME161698207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program