=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467746198
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PADAM BHATIA M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/28/2011
-----------------------------------------------------
Last Update Date | 06/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3250 MARY ST STE 300
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33133-5293
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-908-1115
-----------------------------------------------------
Fax | 305-675-3135
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 382 NE 191ST ST
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33179-3899
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-908-1115
-----------------------------------------------------
Fax | 305-675-3135
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | ME124464
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------