Provider Demographics
NPI:1538867585
Name:BHOWMICK, MEGHNAD (NP,MBBS)
Entity type:Individual
Prefix:
First Name:MEGHNAD
Middle Name:
Last Name:BHOWMICK
Suffix:
Gender:M
Credentials:NP,MBBS
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 4189
Mailing Address - Street 2:
Mailing Address - City:BELLE GLADE
Mailing Address - State:FL
Mailing Address - Zip Code:33430-4189
Mailing Address - Country:US
Mailing Address - Phone:305-684-7557
Mailing Address - Fax:954-363-9655
Practice Address - Street 1:800 NE 1ST ST
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-2012
Practice Address - Country:US
Practice Address - Phone:305-684-7557
Practice Address - Fax:561-781-8070
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1538867585OtherFAMILY MEDICINE
FL8229OtherNURSE PRACTITIONER