Provider Demographics
NPI:1427279488
Name:NIKHIL BHARDWAJ MD PA
Entity type:Organization
Organization Name:NIKHIL BHARDWAJ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BHARDWAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:305-932-2552
Mailing Address - Street 1:21355 E DIXIE HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1238
Mailing Address - Country:US
Mailing Address - Phone:305-932-2552
Mailing Address - Fax:305-932-2503
Practice Address - Street 1:21355 E DIXIE HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1238
Practice Address - Country:US
Practice Address - Phone:305-932-2552
Practice Address - Fax:305-932-2503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79930207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35714OtherBC, BS PROVIDER NUMBER
FLN191965OtherSTAYWELL PROVIDER NUMBER
FL1031917OtherCARE PLUS PROVIDER NUMBER
FL39509OtherNEIGHBORHOOD PROVIDER NUM
FL48-00593OtherUNITED PROVIDER NUMBER
FL7469122OtherAETNA PROVIDER NUMBER
FL222594OtherAMERIGROUP PROVIDER NUMBE
FLH12007OtherVISTA PROVIDER NUMBER
FL261864800Medicaid
FL273491OtherAV MED PROVIDER NUMBER
FLN191965OtherWELLCARE PROVIDER NUMBER
FL222594OtherAMERIGROUP PROVIDER NUMBE
FL7469122OtherAETNA PROVIDER NUMBER
FLH12007Medicare UPIN