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1053376012
MICKEY L BATH
GAINESVILLE, FL
NPI
1053376012
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: FL PA 0002191)
Enumeration Date
2006-04-20
Last Update Date
2010-11-29
Business Address
-- MICKEY L BATH PAC
1600 SW ARCHER RD
GAINESVILLE, FL 32610-3003
Phone number: 352-392-1161
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Mailing Address
-- MICKEY L BATH PAC
PO BOX 918025
ORLANDO, FL 32891-8025
Phone number: 352-392-1161
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