Healthcare Provider Details

I. General information

NPI: 1215317292
Provider Name (Legal Business Name): MEGAN BAINBRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CENTRAL AVE
SARASOTA FL
34236-4042
US

IV. Provider business mailing address

736 CENTRAL AVE
SARASOTA FL
34236-4042
US

V. Phone/Fax

Practice location:
  • Phone: 941-365-3913
  • Fax: 941-366-1899
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP9327262
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9327262
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: