Provider Demographics
NPI:1609545326
Name:PAYAL JHAWAR, MD LLC
Entity Type:Organization
Organization Name:PAYAL JHAWAR, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:JHAWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-519-2376
Mailing Address - Street 1:366 CHANTILLY TRL
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-5020
Mailing Address - Country:US
Mailing Address - Phone:860-519-2376
Mailing Address - Fax:
Practice Address - Street 1:2810 MANATEE AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1828
Practice Address - Country:US
Practice Address - Phone:941-777-5118
Practice Address - Fax:469-242-9547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center