Provider Demographics
NPI:1003798950
Name:DATT, BHARAT (CCP, FPP)
Entity type:Individual
Prefix:
First Name:BHARAT
Middle Name:
Last Name:DATT
Suffix:
Gender:M
Credentials:CCP, FPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12030 SAWGRASS RESERVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-7316
Mailing Address - Country:US
Mailing Address - Phone:407-994-6412
Mailing Address - Fax:
Practice Address - Street 1:5100 ELDORADO PKWY STE 102
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7295
Practice Address - Country:US
Practice Address - Phone:843-708-4915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA360242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist