Provider Demographics
NPI:1699845446
Name:BEDI, BHARMINDER (MD)
Entity Type:Individual
Prefix:
First Name:BHARMINDER
Middle Name:
Last Name:BEDI
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 1:11630 GREENSLEEVE AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626
Mailing Address - Country:US
Mailing Address - Phone:813-925-8455
Mailing Address - Fax:
Practice Address - Street 1:7955 66TH ST N
Practice Address - Street 2:SUITE D
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2161
Practice Address - Country:US
Practice Address - Phone:727-541-3362
Practice Address - Fax:727-544-4015
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME272582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL660052200Medicaid
FL660052200Medicaid
FL79944IMedicare PIN