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NPI Code Detail

MEDICARE: MRS. PATRICIA C BAYSHORE ARNP

MEDICARE: MRS. PATRICIA C BAYSHORE 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
1363LF0000XFamily Nurse PractitionerARNP 9265347FL

General Provider Information

NPI Number : 1679829113
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA C BAYSHORE ARNP
Provider Business Mailing Address
First Line : 47 5TH ST NW
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33881-4672
Country : US
Telephone Number : 863-229-7970
Fax Number :
Provider Business Practice Location Address
First Line : 106 NW 9TH AVE
Second Line :
City : MULBERRY
State : FL
Zip : 33860-2922
Country : US
Telephone Number : 866-234-8534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2012
Last Update Date : 06/03/2020

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