MEDICARE: NAZEEKA BAKSH PA

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
1	363A00000X	Physician Assistant	PA9105375	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992026611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAZEEKA BAKSH PA

Provider Business Mailing Address
First Line	:	14282 ANASTASIA LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-4804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14282 ANASTASIA LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-4804
Country	:	US
Telephone Number	:	650-602-2074
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2010
Last Update Date	:	09/27/2022

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Directions to “ NAZEEKA BAKSH PA” Practice Location

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