Provider Demographics
NPI:1336331008
Name:BHALANI, MAULIK K (MD)
Entity Type:Individual
Prefix:DR
First Name:MAULIK
Middle Name:K
Last Name:BHALANI
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 1:2553 WINDGUARD CIR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7351
Mailing Address - Country:US
Mailing Address - Phone:813-388-2948
Mailing Address - Fax:813-388-6827
Practice Address - Street 1:2553 WINDGUARD CIR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7351
Practice Address - Country:US
Practice Address - Phone:813-388-2948
Practice Address - Fax:813-388-6827
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102285208VP0014X
FLTRN9689390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002563900Medicaid
FLP01510617OtherRR MCR
FL149UNOtherBCBS
FLDK789WMedicare PIN
FLDK789VMedicare PIN
FLDK789XMedicare PIN