Healthcare Provider Details

I. General information

NPI: 1013903327
Provider Name (Legal Business Name): BAHAR SUMBUL-YUKSEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 MAJOR BLVD STE 150
ORLANDO FL
32819-7971
US

IV. Provider business mailing address

6001 VINELAND RD STE 106
ORLANDO FL
32819-7829
US

V. Phone/Fax

Practice location:
  • Phone: 407-409-8118
  • Fax:
Mailing address:
  • Phone: 407-409-8118
  • Fax: 407-930-4522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME129081
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: