Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME116329 | FL |
Y | 2080P0203X | Pediatric Critical Care Doctor | ME 116329 | FL |
NPI | 1144423195 |
---|---|
Provider Name | Sunita Prakash Bhandare |
First Address | Tampa, FL 33647-2787 |
Second Address | Tampa, FL 33647-2787 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 10/12/2021 |