Individual
BHAVANI KETHEESWARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2810 SE 3RD CT, OCALA, FL 34471-0446
(352) 732-0122
Mailing address
2810 SE 3RD CT, OCALA, FL 34471-0446
(352) 732-0122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME82362
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13015
BCBS
FL
05
—
262712400
—
FL
Enumeration date
06/26/2006
Last updated
02/10/2014
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