Provider Demographics
NPI:1730318817
Name:BHALANI, VIRAJ VINAYAK (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRAJ
Middle Name:VINAYAK
Last Name:BHALANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3140 S FALKENBURG RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-2574
Mailing Address - Country:US
Mailing Address - Phone:813-910-8708
Mailing Address - Fax:855-852-7153
Practice Address - Street 1:12662 TELECOM DR
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-0935
Practice Address - Country:US
Practice Address - Phone:813-910-8708
Practice Address - Fax:855-852-7153
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD447055207R00000X
NY268406207R00000X
FLME123975207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLID583YMedicare UPIN