Provider Demographics
NPI:1346456647
Name:BIMBRAHW, PREETI (MD)
Entity Type:Individual
Prefix:
First Name:PREETI
Middle Name:
Last Name:BIMBRAHW
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 1:8095 SPYGLASS HILL RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8290
Mailing Address - Country:US
Mailing Address - Phone:321-241-6400
Mailing Address - Fax:321-428-3945
Practice Address - Street 1:8095 SPYGLASS HILL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8290
Practice Address - Country:US
Practice Address - Phone:321-241-6400
Practice Address - Fax:321-428-3945
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME112749208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics