Individual
ANIL LAXMIDAS BATHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2230 N UNIVERSITY DR, CORAL SPRINGS, FL 33071-6100
(954) 753-3800
Mailing address
2230 N UNIVERSITY DR, CORAL SPRINGS, FL 33071-6100
(954) 753-3800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
36650
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001631100
—
FL
01
—
13772
BLUE CROSS BLUE SHIELD
NC
01
—
561830036
FEDERAL TAX ID
NC
05
—
8913772
—
NC
Enumeration date
07/02/2006
Last updated
04/09/2015
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