MEDICARE: BODY BY BARIATRICS, LLC

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	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1992414684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODY BY BARIATRICS, LLC

Provider Business Mailing Address
First Line	:	12363 W COLONIAL DR STE 120
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-4186
Country	:	US
Telephone Number	:	407-707-5018
Fax Number	:	407-707-8658

Provider Business Practice Location Address
First Line	:	12363 W COLONIAL DR STE 120
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-4186
Country	:	US
Telephone Number	:	407-707-5018
Fax Number	:	407-707-8658

Authorized Official
Title or Position	:	CEO/BARIATRIC SURGEON
Name	:	DR. ELIZABETH ANNE DOVEC
Credential	:	MD
Telephone Number	:	407-707-5018

Provider Enumeration Date	:	11/21/2022
Last Update Date	:	03/25/2026

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