Provider Demographics
NPI:1619070851
Name:BHATIA, LAKHINDER S (MD)
Entity Type:Individual
Prefix:
First Name:LAKHINDER
Middle Name:S
Last Name:BHATIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N JOHN YOUNG PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-6601
Mailing Address - Country:US
Mailing Address - Phone:904-881-0329
Mailing Address - Fax:
Practice Address - Street 1:200 N JOHN YOUNG PKWY STE 102
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:904-881-0329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81873207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261075200Medicaid
FL261075200Medicaid
FL58897Medicare PIN