Bath, Mickey L

Bath, Mickey L is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-3003. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Bath, Mickey L can be contacted via phone (352) 392-1161.

Contact Information

Primary practice address
1600 Sw Archer Rd Gainesville FL 32610-3003
Phone: (352) 392-1161
Fax: (352) 392-5127
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA 0002191 Florida

Profile Details

NPI number 1053376012
LBN Legal business name Bath, Mickey L
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Nov 29th, 2010 - about 14 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 1053376012 NPPES
Florida MEDICAID 002794900

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