Healthcare Provider Details

I. General information

NPI: 1699967877
Provider Name (Legal Business Name): SUNIL ASHOK BHARWANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 SW COLLEGE RD STE 100
OCALA FL
34474-5713
US

IV. Provider business mailing address

3949 SW COLLEGE RD STE 100
OCALA FL
34474-5713
US

V. Phone/Fax

Practice location:
  • Phone: 352-401-8800
  • Fax: 352-401-8882
Mailing address:
  • Phone: 352-401-8800
  • Fax: 352-401-8882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number201567
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME142084
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: