Davis, Breeanna Bacchus

Davis, Breeanna Bacchus is an individual health care provider with primary practice located at 220 Barton Blvd Unit C-14 , Rockledge FL 32955-2742. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Davis, Breeanna Bacchus can be contacted via phone (321) 241-6800.

Contact Information

Primary practice address
220 Barton Blvd Unit C-14 Rockledge FL 32955-2742
Phone: (321) 241-6800
Fax: (321) 241-6890
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9114561 Florida

Profile Details

NPI number 1588233902
LBN Legal business name Davis, Breeanna Bacchus
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2021
Last updated Aug 3rd, 2023 - about 3 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 1588233902 NPPES
Florida Other PA9114561 FL MEDICAL LICENSE
Florida MEDICAID 111974100 FL MEDICAL LICENSE

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