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Organization
RAJNEESH K BHALLA MD PA
Active
Organization
RAJNEESH K BHALLA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJNEESH K BHALLA MD (PRESIDENT)
(772) 398-8844
Entity
Organization
Contact information
Practice address
1701 SE HILLMOOR DR, SUITE C-12, PORT SAINT LUCIE, FL 34952-7541
(772) 398-8844
(772) 398-0012
Mailing address
1701 SE HILLMOOR DR, SUITE C-12, PORT SAINT LUCIE, FL 34952-7541
(772) 398-8844
(772) 398-0012
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME71005
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009389600
—
FL
Enumeration date
02/03/2010
Last updated
11/08/2013
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