MEDICARE: ANIL LAXMIDAS BATHIA M.D.

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	2085R0202X	Diagnostic Radiology Physician	36650	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13772	OTHER	NC	BLUE CROSS BLUE SHIELD
2	561830036	OTHER	NC	FEDERAL TAX ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932138898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIL LAXMIDAS BATHIA M.D.

Provider Business Mailing Address
First Line	:	2230 N UNIVERSITY DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6100
Country	:	US
Telephone Number	:	954-753-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2230 N UNIVERSITY DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6100
Country	:	US
Telephone Number	:	954-753-3800
Fax Number	:

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

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	04/09/2015

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