Rajneesh K Bhalla Md Pa | |
1701 Se Hillmoor Dr Suite C-12 Port Saint Lucie FL 34952-7541 | |
(772) 398-8844 | |
(772) 398-0012 |
Full Name | Rajneesh K Bhalla Md Pa |
---|---|
Speciality | Internal Medicine |
Location | 1701 Se Hillmoor Dr, Port Saint Lucie, Florida |
Authorized Official Name and Position | Rajneesh K Bhalla (PRESIDENT) |
Authorized Official Contact | 7723988844 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Rajneesh K Bhalla Md Pa 1701 Se Hillmoor Dr Suite C-12 Port Saint Lucie FL 34952-7541 Ph: (772) 398-8844 | Rajneesh K Bhalla Md Pa 1701 Se Hillmoor Dr Suite C-12 Port Saint Lucie FL 34952-7541 Ph: (772) 398-8844 |
NPI Number | 1821320789 |
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Provider Enumeration Date | 02/03/2010 |
Last Update Date | 11/08/2013 |
Medicare PECOS PAC ID | 8123154820 |
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Medicare Enrollment ID | O20100406000289 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821320789 | NPI | - | NPPES |
009389600 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME71005 (Florida) | Primary |
Provider Name | Rajneesh K Bhalla |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1326062167 PECOS PAC ID: 7416083118 Enrollment ID: I20100406000259 |
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