Provider Demographics
NPI:1245429919
Name:ASHOK BHAT M.D. PA
Entity Type:Organization
Organization Name:ASHOK BHAT M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:HARIHAR
Authorized Official - Last Name:BHAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-237-1958
Mailing Address - Street 1:613 W DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:101
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-3400
Mailing Address - Country:US
Mailing Address - Phone:813-237-1958
Mailing Address - Fax:813-237-8147
Practice Address - Street 1:613 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:101
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-3400
Practice Address - Country:US
Practice Address - Phone:813-237-1958
Practice Address - Fax:813-237-8147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL39408Medicare PIN