Provider Demographics
NPI:1669826988
Name:BHIMSEN, AMRITA
Entity Type:Individual
Prefix:MISS
First Name:AMRITA
Middle Name:
Last Name:BHIMSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 VILLAGE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1963
Mailing Address - Country:US
Mailing Address - Phone:561-335-5681
Mailing Address - Fax:
Practice Address - Street 1:4620 N STATE ROAD 7 STE 300
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5867
Practice Address - Country:US
Practice Address - Phone:561-335-5681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 247200000X
FL12152752103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other