Provider Demographics
NPI:1689863458
Name:BHADRESHKUMAR PARIKH P A
Entity Type:Organization
Organization Name:BHADRESHKUMAR PARIKH P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BHADRESHKUMAR
Authorized Official - Middle Name:HASMUKHLAL
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-721-8118
Mailing Address - Street 1:7707 N UNIVERSITY DR
Mailing Address - Street 2:STE 207
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2950
Mailing Address - Country:US
Mailing Address - Phone:954-721-8118
Mailing Address - Fax:954-721-8128
Practice Address - Street 1:7707 N UNIVERSITY DR
Practice Address - Street 2:STE 207
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2950
Practice Address - Country:US
Practice Address - Phone:954-721-8118
Practice Address - Fax:954-721-8128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAG667Medicare PIN