MEDICARE: NISHA BHATT

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	225100000X	Physical Therapist	PT24738	FL

General Provider Information

NPI Number	:	1700195757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NISHA BHATT

Provider Business Mailing Address
First Line	:	110 SW 9TH AVE
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33486-4520
Country	:	US
Telephone Number	:	305-923-2777
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 CAMINO GARDENS BLVD STE 104
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-5823
Country	:	US
Telephone Number	:	561-494-4499
Fax Number	:	561-494-4499

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

Provider Enumeration Date	:	09/24/2010
Last Update Date	:	01/21/2022

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