MEDICARE: DR. ARJUN BAMZAI

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	208000000X	Pediatrics Physician	102169	MN
2	208000000X	Pediatrics Physician	ME117339	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	:	1942252184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARJUN BAMZAI

Provider Business Mailing Address
First Line	:	1550 S WATER ST
Second Line	:
City	:	STARKE
State	:	FL
Zip	:	32091-4511
Country	:	US
Telephone Number	:	352-498-1360
Fax Number	:

Provider Business Practice Location Address
First Line	:	149 NE 241ST ST
Second Line	:
City	:	CROSS CITY
State	:	FL
Zip	:	32628-3305
Country	:	US
Telephone Number	:	352-498-1360
Fax Number	:

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	05/22/2020

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Directions to “ DR. ARJUN BAMZAI ” Practice Location

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