| Bautista Medical Group Llc | |
|
5221 Bentgrass Way Bradenton FL 34211-1703 | |
| (910) 920-6505 | |
| Not Available |
| Full Name | Bautista Medical Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5221 Bentgrass Way, Bradenton, Florida |
| Authorized Official Name and Position | Natasha Sharpe (CEO) |
| Authorized Official Contact | 9109206505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bautista Medical Group Llc 5221 Bentgrass Way Bradenton FL 34211-1703 Ph: (910) 920-6505 | Bautista Medical Group Llc 5221 Bentgrass Way Bradenton FL 34211-1703 Ph: (910) 920-6505 |
| NPI Number | 1467112599 |
|---|---|
| Provider Enumeration Date | 12/30/2021 |
| Last Update Date | 03/11/2024 |
| Medicare PECOS PAC ID | 7517345887 |
|---|---|
| Medicare Enrollment ID | O20220528000226 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467112599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Natasha Brooke Sharpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174109409 PECOS PAC ID: 2163828336 Enrollment ID: I20210914001259 |
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