Provider Demographics
NPI:1942208673
Name:BHARGAVA, SANGEETA (MD)
Entity Type:Individual
Prefix:
First Name:SANGEETA
Middle Name:
Last Name:BHARGAVA
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 691597
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-1597
Mailing Address - Country:US
Mailing Address - Phone:407-898-1210
Mailing Address - Fax:407-898-2909
Practice Address - Street 1:615 E PRINCETON ST
Practice Address - Street 2:SUITE 510
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1456
Practice Address - Country:US
Practice Address - Phone:407-898-1210
Practice Address - Fax:407-898-2909
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 677682080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378110100Medicaid
FL26701YMedicare PIN
FL378110100Medicaid