Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME 129303 | FL |
Y | 208600000X | Surgeon | ME 129303 | FL |
N | 2082S0105X | Plastic Hand Surgeon | ME 129303 | FL |
N | 2086S0122X | Plastic and Reconstructive Surgery | ME 129303 | FL |
NPI | 1245784636 |
---|---|
Provider Name | Dinesh Bhargava |
First Address | St Petersburg, FL 33713-8900 |
Second Address | St Petersburg, FL 33713-8900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2016 |
Last Update Date | 26/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
IX030Z | (02) | FL |