Healthcare Provider Details

I. General information

NPI: 1457414393
Provider Name (Legal Business Name): HAROLD BAFITIS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 MILITARY TRL 208
JUPITER FL
33458-4834
US

IV. Provider business mailing address

4601 MILITARY TRL 208
JUPITER FL
33458-4834
US

V. Phone/Fax

Practice location:
  • Phone: 561-795-3787
  • Fax: 561-798-0003
Mailing address:
  • Phone: 561-795-3787
  • Fax: 561-798-0003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberOS5647
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: