Zachary Alexander Bautista, PA-C
Physician Assistant in Gainesville, FL. Individual provider (NPI-1).
NPI number1629638176
StatusActive
Last updated in NPPESMay 6, 2020
Details
- NPI
- 1629638176
- Entity type
- Individual (NPI-1)
- Name
- Zachary Alexander Bautista
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 17, 2019
- Certification date
- May 6, 2020
- Last updated
- May 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA9112449 | FL | Yes |
Practice location
1600 Sw Archer RdGainesville, FL 32610-6954
Phone 352-265-5911 · Fax 352-265-5606
Mailing address
1600 Sw Archer Rd Box 100186Gainesville, FL 32610-0001
Phone 352-265-5911 · Fax 352-265-5606
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