MEDICARE: JAMIN VINOD BRAHMBHATT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	ME 112621	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073714267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIN VINOD BRAHMBHATT MD

Provider Business Mailing Address
First Line	:	1920 DON WICKHAM DR STE 130
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1978
Country	:	US
Telephone Number	:	352-536-8761
Fax Number	:	352-536-8768

Provider Business Practice Location Address
First Line	:	1920 DON WICKHAM DR STE 130
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1978
Country	:	US
Telephone Number	:	352-536-8761
Fax Number	:	352-536-8768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	09/25/2020

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