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General NPI Number Information
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NPI Number | 1427587328
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Entity Type | Individual
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Provider Name | ANASTASIA NICOLE BAHR PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 5385 CONROY RD STE 104
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City | ORLANDO
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State | FL
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Zip | 32811-3719
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Country | US
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Telephone | 407-583-6568
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Fax |
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Provider Business Mailing Address
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Address Line | 316 SKYVIEW PL
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City | CHULUOTA
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State | FL
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Zip | 32766-9539
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Country | US
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Telephone | 407-718-7857
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | FL
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