Provider Demographics
NPI:1669567269
Name:BHAGHANI, MOHAMMAD YOUSUF (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:YOUSUF
Last Name:BHAGHANI
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 1:1800 MERCY DR.
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808
Mailing Address - Country:US
Mailing Address - Phone:407-875-3700
Mailing Address - Fax:407-522-4671
Practice Address - Street 1:1800 MERCY DR.
Practice Address - Street 2:SUITE 302
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808
Practice Address - Country:US
Practice Address - Phone:407-875-3700
Practice Address - Fax:407-522-4671
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME758012084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263113000Medicaid
FL08811ZMedicare ID - Type Unspecified