MEDICARE: DR. NEYSA L BARTLETT D.O.

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	207V00000X	Obstetrics & Gynecology Physician	OS17292	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5791690	OTHER	MI	AETNA
3	P95391	OTHER	MI	BLUE CHOICE & BCN
4	5130061	OTHER	MI	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235102260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEYSA L BARTLETT D.O.

Provider Business Mailing Address
First Line	:	3718-3722 AVALON PARK EAST BOULEVARD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-4805
Country	:	US
Telephone Number	:	407-518-1074
Fax Number	:	407-518-9056

Provider Business Practice Location Address
First Line	:	3718-3722 AVALON PARK EAST BOULEVARD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-4805
Country	:	US
Telephone Number	:	407-518-1074
Fax Number	:	407-518-9056

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	01/02/2024

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