MEDICARE: MARLENE GABY BACHRACH APRN

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	363LA2200X	Adult Health Nurse Practitioner	2983182	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

General Provider Information

NPI Number	:	1982769279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLENE GABY BACHRACH APRN

Provider Business Mailing Address
First Line	:	3601 FEDERAL HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-3795
Country	:	US
Telephone Number	:	305-576-6611
Fax Number	:	786-476-2819

Provider Business Practice Location Address
First Line	:	5040 NW 7TH ST STE 100
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3425
Country	:	US
Telephone Number	:	305-576-6611
Fax Number	:

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

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	09/09/2022

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