Provider Demographics
NPI:1528222452
Name:BHATT ABRAHAM, PAYAL (MD)
Entity Type:Individual
Prefix:
First Name:PAYAL
Middle Name:
Last Name:BHATT ABRAHAM
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 1:7350 SW 60TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-6476
Mailing Address - Country:US
Mailing Address - Phone:352-854-5530
Mailing Address - Fax:352-854-5532
Practice Address - Street 1:7350 SW 60TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-6476
Practice Address - Country:US
Practice Address - Phone:352-854-5530
Practice Address - Fax:352-854-5532
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443586207Q00000X
FLME156528207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102644117Medicaid
PA102644117Medicaid