Provider Demographics
NPI:1477825123
Name:SHIWNARAIN, BHAVESHA (AS)
Entity Type:Individual
Prefix:MISS
First Name:BHAVESHA
Middle Name:
Last Name:SHIWNARAIN
Suffix:
Gender:F
Credentials:AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4721 123RD TRL N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-9075
Mailing Address - Country:US
Mailing Address - Phone:561-889-4157
Mailing Address - Fax:
Practice Address - Street 1:6414 13TH RD S
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33415-1401
Practice Address - Country:US
Practice Address - Phone:561-478-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14955224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant