Individual
SANJEEV BHATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
803 E DIXIE AVE, LEESBURG, FL 34748-6013
(352) 530-2256
(352) 414-4638
Mailing address
803 E DIXIE AVE, LEESBURG, FL 34748-6013
(352) 530-2256
(352) 414-4638
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME 82971
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME82971
FL
207UN0901X
Nuclear Cardiology Physician
ME 82971
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09012
BCBS
FL
05
—
263891600
—
FL
Enumeration date
08/31/2005
Last updated
04/01/2014
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