Healthcare Provider Details

I. General information

NPI: 1154536480
Provider Name (Legal Business Name): NANCY W BACHER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 NE 191ST ST STE 705
AVENTURA FL
33180-3386
US

IV. Provider business mailing address

2999 NE 191ST ST STE 705
AVENTURA FL
33180-3386
US

V. Phone/Fax

Practice location:
  • Phone: 305-935-0540
  • Fax: 305-937-0625
Mailing address:
  • Phone: 305-935-0540
  • Fax: 305-937-0625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPY3496
License Number StateFL

VIII. Authorized Official

Name: DR. NANCY BACHER
Title or Position: PRESIDENT
Credential: PSY.D
Phone: 305-935-0540