Provider Demographics
NPI:1376938415
Name:ANIL M BHATIA MD PA
Entity Type:Organization
Organization Name:ANIL M BHATIA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:BHATIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-975-1501
Mailing Address - Street 1:PO BOX 341829
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33694-1829
Mailing Address - Country:US
Mailing Address - Phone:813-975-1501
Mailing Address - Fax:813-975-1505
Practice Address - Street 1:14447 BRUCE B DOWNS
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3741
Practice Address - Country:US
Practice Address - Phone:813-975-1501
Practice Address - Fax:813-975-1505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0073647207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty