Provider Demographics
NPI:1720747470
Name:DORA BHAI, SHEEJA (APRN)
Entity type:Individual
Prefix:
First Name:SHEEJA
Middle Name:
Last Name:DORA BHAI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 QUEEN ALEXANDRIA DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-9103
Mailing Address - Country:US
Mailing Address - Phone:352-455-1940
Mailing Address - Fax:
Practice Address - Street 1:3109 QUEEN ALEXANDRIA DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-9103
Practice Address - Country:US
Practice Address - Phone:352-455-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11013817363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily