Mahesh Bhambore MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME100193 Issued in FL

Legal business name

MAHESH BHAMBORE MD PA

Practice address

21762 State Road 54
Lutz, FL 33549-6921

Phone

(727) 403-4573

NPI assigned

Jan 8, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mahesh Bhambore, M.DNPI 1336183573

Title

President

Phone

(727) 403-4573

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sunstate Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mahesh Bhambore, M.D.

  • Internal Medicine Physician
  • Lutz, FL
  • NPI 1336183573
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372204800000",
    "number": "1831436005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20016 RYMAN PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21762 STATE ROAD 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496921",
            "telephone_number": "727-403-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHESH BHAMBORE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-06-26",
        "status": "A",
        "authorized_official_last_name": "BHAMBORE",
        "authorized_official_first_name": "MAHESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-403-4573",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME100193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P01173486",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunstate Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adrienne Maddox, M.S., CCC-SLP
• Abby Noreen Madlener
• Magnolia Manor Assisted Living, Inc.
• Maya V Maharana, SLP
• Richa Mahatme, DDS
• Gabrielle Mai, APRN
• Phoebe Aimel Maisto, LMHC
• Faddy A Makaryus, DMD
• Kevin J. Makati, MD
• Viba Bhuvana Malaiyandi, MD

• Internal Medicine Physician in Lutz, FL
• Providers in Lutz, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.