Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | ME110155 | FL |
Y | 207RI0011X | Interventional Cardiology | ME110155 | FL |
N | 2086S0129X | Vascular Surgeon | ME110155 | FL |
NPI | 1013995406 |
---|---|
Provider Name | Janak Hirabhai Bhavsar |
First Address | Daytona Beach, FL 32114-2321 |
Second Address | Orange City, FL 32763-8305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005954200 | (05) | FL |
14L3S | BC/BS (01) | FL |