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NPI Code Detail

MEDICARE: JAVIER ALFONSO BAUTISTA ARNP

MEDICARE: JAVIER ALFONSO BAUTISTA ARNP
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
1363LA2100XAcute Care Nurse PractitionerARNP11008106FL

General Provider Information

NPI Number : 1386253656
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAVIER ALFONSO BAUTISTA ARNP
Provider Business Mailing Address
First Line : 8370 W FLAGLER ST STE 226
Second Line :
City : MIAMI
State : FL
Zip : 33144-2040
Country : US
Telephone Number : 305-785-1348
Fax Number : 305-630-3632
Provider Business Practice Location Address
First Line : 5000 W OAKLAND PARK BLVD
Second Line :
City : LAUDERDALE LAKES
State : FL
Zip : 33313-1585
Country : US
Telephone Number : 305-928-7249
Fax Number : 305-630-3632
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2020
Last Update Date : 03/20/2026

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