Amir Bacchus, M. D. Ltd
Clinic/Center in Henderson, NV. Organization (NPI-2).
NPI number1154495232
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1154495232
- Entity type
- Organization (NPI-2)
- Legal business name
- Amir Bacchus, M. D. Ltd
- Organization subpart
- No
- Enumeration date
- Nov 20, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
1701 N Green Valley PkwyHenderson, NV 89074-5885
Phone 407-316-3130 · Fax 407-316-3001
Mailing address
801 N Magnolia AveSuite 405
Orlando, FL 32803-3851
Phone 407-316-3130 · Fax 407-316-3001
Authorized official
Amir Bacchus
Sole Owner
4073163130
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