Provider Demographics
NPI:1740292549
Name:BHAT, CHANDRAHAS V (MD)
Entity type:Individual
Prefix:
First Name:CHANDRAHAS
Middle Name:V
Last Name:BHAT
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 1:5216 SW 5TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6504
Mailing Address - Country:US
Mailing Address - Phone:239-945-0893
Mailing Address - Fax:
Practice Address - Street 1:601 W ALVERDEZ AVE
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3504
Practice Address - Country:US
Practice Address - Phone:863-983-1423
Practice Address - Fax:863-983-1426
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME754762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269997400Medicaid
FLD31134Medicare UPIN
FL42961Medicare ID - Type Unspecified