Healthcare Provider Details

I. General information

NPI: 1639433303
Provider Name (Legal Business Name): DARPAN GIRISHKUMAR BHUVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH FL
32117-5167
US

IV. Provider business mailing address

PO BOX 945921
ATLANTA GA
30394-5921
US

V. Phone/Fax

Practice location:
  • Phone: 386-231-1091
  • Fax: 386-231-1092
Mailing address:
  • Phone: 386-231-4529
  • Fax: 386-672-9904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME141537
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: