Healthcare Provider Details

I. General information

NPI: 1720043037
Provider Name (Legal Business Name): ANDREA ILENE BAYER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 03/29/2025
Certification Date: 03/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10115 FOREST HILL BLVD SUITE 103
WELLINGTON FL
33414-3105
US

IV. Provider business mailing address

10115 FOREST HILL BLVD SUITE 103
WELLINGTON FL
33414-3105
US

V. Phone/Fax

Practice location:
  • Phone: 561-328-6165
  • Fax: 561-328-6091
Mailing address:
  • Phone: 561-328-6165
  • Fax: 561-328-6091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME64800
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME64800
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: