Provider Demographics
NPI:1841285277
Name:BHATTI, LAVEEZA (MD)
Entity type:Individual
Prefix:
First Name:LAVEEZA
Middle Name:
Last Name:BHATTI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8390 CHAMPIONS GATE BLVD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CHAMPIONS GATE
Mailing Address - State:FL
Mailing Address - Zip Code:33896-8310
Mailing Address - Country:US
Mailing Address - Phone:407-390-1677
Mailing Address - Fax:407-390-1765
Practice Address - Street 1:99 NORTH LA CIENEGA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2285
Practice Address - Country:US
Practice Address - Phone:310-657-9353
Practice Address - Fax:310-657-9367
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2020-06-22
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Provider Licenses
StateLicense IDTaxonomies
CAA54090207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG85031Medicare UPIN