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General NPI Number Information
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NPI Number | 1457617656
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Entity Type | Individual
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Provider Name | BHAVTOSH KANJI DEDANIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 602 VONDERBURG DR STE 101
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City | BRANDON
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State | FL
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Zip | 33511-5900
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Country | US
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Telephone | 813-685-5500
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Fax | 813-653-1379
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Provider Business Mailing Address
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Address Line | 602 VONDERBURG DR STE 101
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City | BRANDON
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State | FL
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Zip | 33511-5900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME144117
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License Number State | FL
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