Provider Demographics
NPI:1184097966
Name:HARTLEY, BHUMI (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:BHUMI
Middle Name:
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 SW 20TH PL
Mailing Address - Street 2:STE 100
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7881
Mailing Address - Country:US
Mailing Address - Phone:352-237-1212
Mailing Address - Fax:352-237-0066
Practice Address - Street 1:224 SE 24TH STREET
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32641
Practice Address - Country:US
Practice Address - Phone:352-334-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9109144363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant