Provider Information for 1770544298
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JATIN BIDANI
Sex: Male
NPI: 1770544298
Last Updated: 2011-10-31
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1770544298 | ||||||||
| Enumeration Date | 2006-04-01 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 3280 SEMINOLE, FL 33775-3280 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 8787 BRYAN DAIRY RD SUITE 310 LARGO, FL 33777-1251 United States Phone: 727-393-1155 | Fax:727-320-9634 | ||||||||
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