# BHAKTA OPTOMETRIC, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417265455
- **Authorized official:** DR. HETEL BHAKTA O.D. (OPTOMETRIST)
- **Authorized official phone:** (978) 457-0557

## Contact information

- **Practice address:** 8755 HYPOLUXO RD STE 2, LAKE WORTH, FL 33467-5316
- **Practice address phone:** (978) 457-0557
- **Mailing address:** 8755 HYPOLUXO RD STE 2, LAKE WORTH, FL 33467-5316
- **Mailing address phone:** (978) 457-0557

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC 4297 | FL | Yes |

## Other

- **Enumeration date:** 09/23/2010
- **Last updated:** 03/18/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001645200 | — | FL |
| 01 | — | BV5192 | MEDICARE PTAN | FL |