Bacchus, Fara

Bacchus, Fara is an individual health care provider with primary practice located at 832 W Central Blvd , Orlando FL 32805-1809. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Bacchus, Fara can be contacted via phone (407) 858-1400.

Contact Information

Primary practice address
832 W Central Blvd Orlando FL 32805-1809
Phone: (407) 858-1400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X ARNP 3036332 Florida

Profile Details

NPI number 1235672411
LBN Legal business name Bacchus, Fara
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2016
Last updated Dec 20th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235672411 NPPES
Florida MEDICAID 020035000

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