Provider Demographics
NPI:1841647211
Name:BHAKTA, CHANDNI
Entity type:Individual
Prefix:
First Name:CHANDNI
Middle Name:
Last Name:BHAKTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHANDNI
Other - Middle Name:
Other - Last Name:BHAKTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:9800 US HIGHWAY 441
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-3975
Mailing Address - Country:US
Mailing Address - Phone:352-431-3168
Mailing Address - Fax:352-460-0328
Practice Address - Street 1:9800 US HIGHWAY 441
Practice Address - Street 2:SUITE 101
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-3975
Practice Address - Country:US
Practice Address - Phone:352-431-3168
Practice Address - Fax:352-460-0328
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31177225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist