Individual
BHARATHRAM VASUDEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-8610
Mailing address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125074909
IL
207L00000X
Anesthesiology Physician
Primary
ME164957
FL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
ME164957
FL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
R-11367
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121919400
—
FL
Enumeration date
08/13/2018
Last updated
09/05/2024
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