Provider Demographics
NPI:1285735373
Name:MONICA K BEDI MD PA
Entity type:Organization
Organization Name:MONICA K BEDI MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BEDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-927-5178
Mailing Address - Street 1:PO BOX 850001
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0147
Mailing Address - Country:US
Mailing Address - Phone:941-927-5178
Mailing Address - Fax:941-921-6838
Practice Address - Street 1:3830 BEE RIDGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1105
Practice Address - Country:US
Practice Address - Phone:941-927-5178
Practice Address - Fax:941-921-6838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79670174400000X
207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7670411OtherAETNA
FLP00256517OtherRR MEDICARE M BEDI
FL2201112OtherGHI GROUP
FLDD8628OtherRR MEDICARE GROUP
FL2201112OtherGHI GROUP
FL00479OtherUNIVERSAL HC D WEST
FL13258OtherBCBS OF FL
FL2201112OtherGHI GROUP
FLQ54818Medicare UPIN
FLH68774Medicare UPIN
FL13258YMedicare ID - Type UnspecifiedMONICA K BEDI MD PA
FL00479OtherUNIVERSAL HC D WEST