Healthcare Provider Details

I. General information

NPI: 1891547642
Provider Name (Legal Business Name): BAHAR REHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 01/10/2025
Certification Date:
Deactivation Date: 11/11/2024
Reactivation Date: 01/10/2025

III. Provider practice location address

7485 SW 17TH ROAD, NORTH FLORIDA INTERNAL MEDICINE (TOWER RD) CLINIC
GAINESVILLE FL
32607
US

IV. Provider business mailing address

7485 SW 17TH ROAD, NORTH FLORIDA INTERNAL MEDICINE (TOWER RD) CLINIC
GAINESVILLE FL
32607
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-5700
  • Fax:
Mailing address:
  • Phone: 352-333-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: