Provider Demographics
NPI:1053902841
Name:BRAHMBHATT, SWETABEN
Entity type:Individual
Prefix:
First Name:SWETABEN
Middle Name:
Last Name:BRAHMBHATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N FLAGLER DR APT 321
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6564
Mailing Address - Country:US
Mailing Address - Phone:201-377-8112
Mailing Address - Fax:
Practice Address - Street 1:1801 N FLAGLER DR APT 321
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6564
Practice Address - Country:US
Practice Address - Phone:201-377-8112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010930363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care