Healthcare Provider Details

I. General information

NPI: 1952821910
Provider Name (Legal Business Name): ASHLEY DELORES BEDNER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-2032
US

IV. Provider business mailing address

PO BOX 100296
GAINESVILLE FL
32610-1110
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0462
  • Fax: 352-265-0443
Mailing address:
  • Phone: 352-265-0462
  • Fax: 352-265-0443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberOS16793
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: