=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326011925
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE A BAUER MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2006
-----------------------------------------------------
Last Update Date | 12/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3113 LAWTON RD STE 100
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32803-3519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-894-3241
-----------------------------------------------------
Fax | 407-896-9863
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3113 LAWTON RD STE 100
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32803-3519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-894-3241
-----------------------------------------------------
Fax | 407-896-9863
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | ME0067923
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------