=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740120617
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAA BHAWANI INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2026
-----------------------------------------------------
Last Update Date | 03/31/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5691 S SUNCOAST BLVD
-----------------------------------------------------
City | HOMOSASSA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34446-2605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-628-0096
-----------------------------------------------------
Fax | 855-274-7393
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5691 S SUNCOAST BLVD
-----------------------------------------------------
City | HOMOSASSA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34446-2605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-628-0096
-----------------------------------------------------
Fax | 855-274-7393
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RAJESHBHAI PATEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 352-270-2281
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------