Provider Demographics
NPI:1003487372
Name:BHALLI, HAMZA
Entity type:Individual
Prefix:
First Name:HAMZA
Middle Name:
Last Name:BHALLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 N PINE ISLAND RD STE 214
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5223
Mailing Address - Country:US
Mailing Address - Phone:702-544-9185
Mailing Address - Fax:
Practice Address - Street 1:1776 N PINE ISLAND RD STE 214
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5223
Practice Address - Country:US
Practice Address - Phone:954-452-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME173393207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology