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General NPI Number Information
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NPI Number | 1538558119
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Entity Type | Organization
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Legal Business Name | M PATRICIA BEDOYA MD
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Dates
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Enumeration Date | 01/20/2015
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Last Update Date | 01/20/2015
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Provider Practice Location Address
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Address Line | 183 NW GWEN LAKE AVE
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City | LAKE CITY
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State | FL
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Zip | 32055-3711
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Country | US
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Telephone | 386-752-0442
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Fax | 386-719-4752
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Provider Business Mailing Address
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Address Line | 183 NW GWEN LAKE AVE
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City | LAKE CITY
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State | FL
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Zip | 32055-3711
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Country | US
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Telephone | 386-752-0442
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Fax | 386-719-4752
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIA P BEDOYA
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Credential | M.D.
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Telephone | 386-752-0442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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