Basic Information
| Provider Information | |||||||||
| NPI: | 1831537729 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BHAT | ||||||||
| FirstName: | SHUBHA | ||||||||
| MiddleName: | LAKSHMI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1395 NW 167TH ST APT 1101 | ||||||||
| Address2: | |||||||||
| City: | MIAMI GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331695710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056286117 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6530 HULL STREET RD | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8046743425 | ||||||||
| FaxNumber: | 8045545388 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2013 | ||||||||
| LastUpdateDate: | 10/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD459670 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 0101265437 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.