Healthcare Provider Details

I. General information

NPI: 1275709818
Provider Name (Legal Business Name): RABINDER SINGH BHATTI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2008
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1671 N CLYDE MORRIS BLVD STE 100
DAYTONA BEACH FL
32117-5590
US

IV. Provider business mailing address

1671 N CLYDE MORRIS BLVD STE 100
DAYTONA BEACH FL
32117-5590
US

V. Phone/Fax

Practice location:
  • Phone: 386-274-2977
  • Fax: 386-274-2997
Mailing address:
  • Phone: 386-274-2977
  • Fax: 386-274-2997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberOS11266
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberOS11266
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberOS11266
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: