Healthcare Provider Details

I. General information

NPI: 1902306426
Provider Name (Legal Business Name): CYRUS BHADHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 E FLETCHER AVE
TAMPA FL
33613-4706
US

IV. Provider business mailing address

3515 E FLETCHER AVE
TAMPA FL
33613-4706
US

V. Phone/Fax

Practice location:
  • Phone: 813-821-8032
  • Fax:
Mailing address:
  • Phone: 813-821-8032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101285406
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME180396
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: