Healthcare Provider Details

I. General information

NPI: 1336978352
Provider Name (Legal Business Name): AREEJ BAYARI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 59TH ST W
BRADENTON FL
34209-4604
US

IV. Provider business mailing address

1535 RIVER PARKWAY BLVD APT 419
SHREVEPORT LA
71104-1805
US

V. Phone/Fax

Practice location:
  • Phone: 941-792-6611
  • Fax:
Mailing address:
  • Phone: 813-909-5403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberUO10906
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: