Provider Demographics
NPI:1871650192
Name:BHUTTA, MUHAMMAD JAVID (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:JAVID
Last Name:BHUTTA
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 1:10301 EMERALD WOODS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5936
Mailing Address - Country:US
Mailing Address - Phone:606-416-2476
Mailing Address - Fax:
Practice Address - Street 1:10301 EMERALD WOODS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-5936
Practice Address - Country:US
Practice Address - Phone:606-416-2476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39768207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY39768OtherMEDICAL LICENSE
KYPENDINGMedicaid
KYPENDINGMedicaid
KYPENDINGMedicaid
KY00346012Medicare PIN
KYI73411Medicare UPIN