Provider Demographics
NPI:1790837086
Name:BHATTACHARJEE, LAKSHMISRI (MD)
Entity Type:Individual
Prefix:
First Name:LAKSHMISRI
Middle Name:
Last Name:BHATTACHARJEE
Suffix:
Gender:F
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:PO BOX 1428
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33780-1428
Mailing Address - Country:US
Mailing Address - Phone:727-542-5599
Mailing Address - Fax:
Practice Address - Street 1:5826 LONG BAYOU WAY S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33708-3530
Practice Address - Country:US
Practice Address - Phone:727-542-5599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79890207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3594800OtherCIGNA
FL35571OtherBLUE CROSS BLUE SHEILD FL
FL3563524OtherAETNA
FLN233149OtherWELL CARE
FL266866100Medicaid
FLDC1527OtherRAIL ROAD MEDICARE
FL48-01008OtherUNITED HEALTH CARE
FLN233149OtherPINELLAS COUNTY HUMAN SER
FL11230301OtherCITRUS HEALTH CARE
FLG22441Medicare UPIN
FL266866100Medicaid
FL11230301OtherCITRUS HEALTH CARE