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Individual

DR. BHANU VISVALINGAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2824 ENTERPRISE RD, ORANGE CITY, FL 32763-8428
(386) 774-7411
(386) 774-7412
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200

Taxonomy

Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME96546
FL
207RH0003X
Hematology & Oncology Physician
ME 96546
FL
207RH0003X
Hematology & Oncology Physician
ME96546
FL
207RX0202X
Medical Oncology Physician
Primary
ME96546
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2767441-00
FL
Enumeration date
08/30/2005
Last updated
01/27/2025
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