Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A122965 | CA |
Y | 207QA0505X | Family Doctor - Adult Medicine | ME126694 | FL |
NPI | 1124373212 |
---|---|
Provider Name | Dr. Ami Bhatt |
First Address | Melbourne, FL 32940-1325 |
Second Address | Melbourne, FL 32940-2006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 02/11/2016 |