Provider Demographics
NPI:1336143270
Name:BHULLAR, AMANPREET S (MD)
Entity Type:Individual
Prefix:
First Name:AMANPREET
Middle Name:S
Last Name:BHULLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 N WESTMONTE DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3345
Mailing Address - Country:US
Mailing Address - Phone:407-389-5300
Mailing Address - Fax:407-389-5363
Practice Address - Street 1:9679 LAKE NONA VILLAGE PL
Practice Address - Street 2:SUITE 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7310
Practice Address - Country:US
Practice Address - Phone:407-277-9242
Practice Address - Fax:407-636-7805
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0086331207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280520100Medicaid
FL280520100Medicaid
FLAJ764ZMedicare PIN
FLAJ764XMedicare PIN