# M PATRICIA BEDOYA MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538558119
- **Authorized official:** DR. MARIA P BEDOYA M.D. (OWNER)
- **Authorized official phone:** (386) 752-0442

## Contact information

- **Practice address:** 183 NW GWEN LAKE AVE, LAKE CITY, FL 32055-3711
- **Practice address phone:** (386) 752-0442
- **Practice address fax:** (386) 719-4752
- **Mailing address:** 183 NW GWEN LAKE AVE, LAKE CITY, FL 32055-3711
- **Mailing address phone:** (386) 752-0442
- **Mailing address fax:** (386) 719-4752

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/20/2015
- **Last updated:** 01/20/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 12040 | FLORIDA BLUE | FL |
| 05 | — | 202713500 | — | FL |