Provider Demographics
NPI:1851617427
Name:JHAWAR, PAYAL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAYAL
Middle Name:
Last Name:JHAWAR
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 1:366 CHANTILLY TRL
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-5020
Mailing Address - Country:US
Mailing Address - Phone:860-519-2376
Mailing Address - Fax:
Practice Address - Street 1:2810 MANATEE AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1828
Practice Address - Country:US
Practice Address - Phone:941-777-5118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52087207R00000X
FLME122848207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016754300Medicaid
FLIM343ZMedicare PIN