Provider Demographics
NPI:1710575840
Name:SWAROOP, BHAVIKA
Entity Type:Individual
Prefix:
First Name:BHAVIKA
Middle Name:
Last Name:SWAROOP
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 1:9626 NW 48TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5116
Mailing Address - Country:US
Mailing Address - Phone:954-826-8824
Mailing Address - Fax:
Practice Address - Street 1:350 NW 84TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1820
Practice Address - Country:US
Practice Address - Phone:954-370-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116563363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant