Provider Demographics
NPI:1295110328
Name:ACHHODWALA, BHUMIKA
Entity type:Individual
Prefix:
First Name:BHUMIKA
Middle Name:
Last Name:ACHHODWALA
Suffix:
Gender:F
Credentials:
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 2998
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32790-2998
Mailing Address - Country:US
Mailing Address - Phone:407-252-4651
Mailing Address - Fax:407-641-8633
Practice Address - Street 1:941 W MORSE BLVD # 130
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3734
Practice Address - Country:US
Practice Address - Phone:407-252-4651
Practice Address - Fax:407-641-8633
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1720144371OtherNPI
FL811677600Medicaid
FL331129508OtherEIN