MEDICARE: DR. WYLENE N BHANJI DO

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	207P00000X	Emergency Medicine Physician	OS9034	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	37641	OTHER	FL	BCBS FL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518924166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WYLENE N BHANJI DO

Provider Business Mailing Address
First Line	:	12058 SAN JOSE BLVD STE 1004
Second Line	:	CARING PHYSICAL REHABILITATION
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8667
Country	:	US
Telephone Number	:	904-288-8060
Fax Number	:

Provider Business Practice Location Address
First Line	:	12058 SAN JOSE BLVD STE 1004
Second Line	:	CARING PHYSICAL REHABILITATION
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8667
Country	:	US
Telephone Number	:	904-288-8060
Fax Number	:

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	08/05/2009

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