MEDICARE: SHIVANK BHATIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	MFC1602	FL
2	2085R0204X	Vascular & Interventional Radiology Physician	ME100945	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528151321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIVANK BHATIA MD

Provider Business Mailing Address
First Line	:	3251 E STONEBROOK CIR
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33330-1293
Country	:	US
Telephone Number	:	305-979-9602
Fax Number	:	469-405-4958

Provider Business Practice Location Address
First Line	:	13722 S JOG RD STE A
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-5909
Country	:	US
Telephone Number	:	561-560-0723
Fax Number	:	469-405-4958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	05/09/2025

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Directions to “ SHIVANK BHATIA MD” Practice Location

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