Individual
RAHUL BHALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17075 CAGAN RIDGE BLVD STE 100, CLERMONT, FL 34714-9619
(863) 588-4775
(863) 422-7664
Mailing address
PO BOX 878, DAVENPORT, FL 33836-0878
(689) 223-3898
(689) 223-3898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125.079765
IL
207Q00000X
Family Medicine Physician
ME173109
FL
208D00000X
General Practice Physician
Primary
ME173109
FL
Other
Enumeration date
05/18/2022
Last updated
04/06/2026
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