Provider Demographics
NPI:1598259863
Name:DHALIWAL, BHALINDER (MS,MCH)
Entity type:Individual
Prefix:DR
First Name:BHALINDER
Middle Name:
Last Name:DHALIWAL
Suffix:
Gender:M
Credentials:MS,MCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33601-1289
Mailing Address - Country:US
Mailing Address - Phone:813-660-6950
Mailing Address - Fax:
Practice Address - Street 1:5 TAMPA GENERAL CIR STE 860
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3573
Practice Address - Country:US
Practice Address - Phone:813-660-6950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.245402208G00000X
FLME170267208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)