Healthcare Provider Details

I. General information

NPI: 1154225910
Provider Name (Legal Business Name): ESHA BRAHMBHATT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 SW HIGHWAY 200 STE 1001
OCALA FL
34481-9613
US

IV. Provider business mailing address

2801 MISTY MARBLE DR
ZEPHYRHILLS FL
33540-7455
US

V. Phone/Fax

Practice location:
  • Phone: 352-837-1500
  • Fax:
Mailing address:
  • Phone: 713-377-8088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9122106
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: