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General NPI Number Information
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NPI Number | 1417265455
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Entity Type | Organization
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Legal Business Name | BHAKTA OPTOMETRIC, INC
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 8755 HYPOLUXO RD STE 2
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City | LAKE WORTH
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State | FL
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Zip | 33467-5316
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Country | US
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Telephone | 978-457-0557
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Fax |
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Provider Business Mailing Address
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Address Line | 8755 HYPOLUXO RD STE 2
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City | LAKE WORTH
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State | FL
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Zip | 33467-5316
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Country | US
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Telephone | 978-457-0557
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. HETEL BHAKTA
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Credential | O.D.
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Telephone | 978-457-0557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 4297
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License Number State | FL
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