Provider Demographics
NPI:1568060762
Name:BAWANY LLC
Entity Type:Organization
Organization Name:BAWANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:UZAIR
Authorized Official - Last Name:BAWANY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-234-7858
Mailing Address - Street 1:15130 SPRINGVIEW ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2332
Mailing Address - Country:US
Mailing Address - Phone:954-234-7858
Mailing Address - Fax:
Practice Address - Street 1:15130 SPRINGVIEW ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2332
Practice Address - Country:US
Practice Address - Phone:954-234-7858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental