Provider Demographics
NPI:1881616837
Name:BHUTA, PRIYA MAHESH (OD)
Entity type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:MAHESH
Last Name:BHUTA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5005 MAXWELL CIR
Mailing Address - Street 2:201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-4530
Mailing Address - Country:US
Mailing Address - Phone:954-868-6219
Mailing Address - Fax:239-455-4877
Practice Address - Street 1:9885 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-2638
Practice Address - Country:US
Practice Address - Phone:239-775-5791
Practice Address - Fax:239-455-4877
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3641152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0379AMedicare UPIN