Individual
DR. MANOJ BHATIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 E DIXIE AVE, SUITE 104, LEESBURG, FL 34748-7601
(352) 365-2583
(352) 728-6749
Mailing address
734 N 3RD ST, SUITE 115, LEESBURG, FL 34748-5285
(352) 365-2583
(352) 728-6749
Taxonomy
Speciality
Code
Description
License number
State
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
ME73058
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME73058
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251963100
—
FL
01
—
300099875
RR MEDICARE LMIV
FL
01
—
300114865
RR MEDICARE RACF
FL
Enumeration date
05/04/2006
Last updated
02/24/2016
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