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NPI Code Detail

MEDICARE: BATWOMAN INC

MEDICARE: BATWOMAN INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ARNP9348141OTHERFLSTATE LICENSE

General Provider Information

NPI Number : 1740701275
Entity Type Code : Organization
Provider Name (Legal Business Name) : BATWOMAN INC
Provider Business Mailing Address
First Line : 6817 SOUTHPOINT PKWY STE 203
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-6286
Country : US
Telephone Number : 904-330-1024
Fax Number : 904-330-1027
Provider Business Practice Location Address
First Line : 6817 SOUTHPOINT PKWY STE 203
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-6286
Country : US
Telephone Number : 904-330-1024
Fax Number : 904-330-1027
Authorized Official
Title or Position : OWNER
Name : BRIANNA RIVAS
Credential : ARNP
Telephone Number : 904-330-1024
Provider Enumeration Date : 07/06/2017
Last Update Date : 07/21/2022

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Directions to “BATWOMAN INC ” Practice Location

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