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Organization
MAHESH BHAMBORE MD PA
Active
Organization
MAHESH BHAMBORE MD PA
Active
Other names
Sunstate Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MAHESH BHAMBORE M.D (PRESIDENT)
(727) 403-4573
Entity
Organization
Contact information
Practice address
21762 STATE ROAD 54, LUTZ, FL 33549-6921
(727) 403-4573
Mailing address
20016 RYMAN PL, TAMPA, FL 33647-3452
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME100193
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01173486
RR MCR
FL
Enumeration date
01/08/2013
Last updated
06/26/2013
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