Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME122792 | FL |
N | 111NI0900X | Internist | ME122792 | FL |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME122792 | FL |
NPI | 1063857001 |
---|---|
Provider Name | Rajat Bhalla |
First Address | West Palm Beach, FL 33401-3430 |
Second Address | West Palm Beach, FL 33401-3430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2013 |
Last Update Date | 08/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018970700 | (05) | FL |