Healthcare Provider Details

I. General information

NPI: 1518355262
Provider Name (Legal Business Name): BHAKTIDEVI MAKADIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2015
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 W 8TH ST
JACKSONVILLE FL
32209-6533
US

IV. Provider business mailing address

PO BOX 44008
JACKSONVILLE FL
32231-4008
US

V. Phone/Fax

Practice location:
  • Phone: 904-383-1013
  • Fax: 904-244-4431
Mailing address:
  • Phone: 904-383-1013
  • Fax: 904-244-4431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME153835
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: