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General NPI Number Information
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NPI Number | 1770544298
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Entity Type | Individual
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Provider Name | JATIN BIDANI
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Gender | Male
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Dates
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Enumeration Date | 04/01/2006
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Last Update Date | 10/31/2011
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Provider Practice Location Address
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Address Line | 8787 BRYAN DAIRY RD SUITE 310
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City | LARGO
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State | FL
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Zip | 33777-1251
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Country | US
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Telephone | 727-393-1155
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Fax | 727-320-9634
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Provider Business Mailing Address
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Address Line | PO BOX 3280
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City | SEMINOLE
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State | FL
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Zip | 33775-3280
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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 | ME 68608
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License Number State | FL
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