Healthcare Provider Details

I. General information

NPI: 1154765964
Provider Name (Legal Business Name): ASHISH BHATT, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 E ATLANTIC BLVD
POMPANO BEACH FL
33060-6345
US

IV. Provider business mailing address

721 E ATLANTIC BLVD
POMPANO BEACH FL
33060-6345
US

V. Phone/Fax

Practice location:
  • Phone: 954-783-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME96991
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberME96991
License Number StateFL

VIII. Authorized Official

Name: DR. ASHISH BHATT
Title or Position: OWNER
Credential: M.D.
Phone: 954-980-2700