Bagloo, Melissa Bahareh

Bagloo, Melissa Bahareh is an individual health care provider with primary practice located at 1925 Mizell Ave Ste 201 , Winter Park FL 32792-4155. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Bagloo, Melissa Bahareh can be contacted via phone (407) 303-7399.

Contact Information

Primary practice address
1925 Mizell Ave Ste 201 Winter Park FL 32792-4155
Phone: (407) 303-7399
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 246679-1 New York
Allopathic & Osteopathic Physicians / Surgery 208600000X 25MA08805600 New Jersey
Allopathic & Osteopathic Physicians / Surgery 208600000X ME146371 Florida

Profile Details

NPI number 1407016108
LBN Legal business name Bagloo, Melissa Bahareh
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2008
Last updated Apr 20th, 2022 - about 2 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 1407016108 NPPES
New York MEDICAID 03112663

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