MEDICARE: MS. TINA L BAYER ACNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	301966	NY

General Provider Information

NPI Number	:	1023547452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TINA L BAYER ACNP-BC

Provider Business Mailing Address
First Line	:	7781 REFLECTION COVE DR APT 304
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-6566
Country	:	US
Telephone Number	:	516-695-9673
Fax Number	:

Provider Business Practice Location Address
First Line	:	7781 REFLECTION COVE DR APT 304
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-6566
Country	:	US
Telephone Number	:	516-695-9673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	11/15/2024

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