Provider Demographics
NPI:1609853944
Name:PADALIA, BHARAT GOKALDAS (MD)
Entity Type:Individual
Prefix:
First Name:BHARAT
Middle Name:GOKALDAS
Last Name:PADALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 861342
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-1342
Mailing Address - Country:US
Mailing Address - Phone:813-985-5992
Mailing Address - Fax:813-985-5982
Practice Address - Street 1:119 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5779
Practice Address - Country:US
Practice Address - Phone:813-985-5992
Practice Address - Fax:813-985-5982
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46218207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL042894900Medicaid
050043968OtherRAILROAD MEDICARE
FL30895OtherBCBS
050043968OtherRAILROAD MEDICARE
FL30895OtherBCBS