Individual
BETHANY A CAZENAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(614) 210-1885
(614) 210-1886
Mailing address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(614) 210-1885
(614) 210-1886
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME92977
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03532
BCBS
FL
05
—
106359
—
AL
05
—
106360
—
AL
05
—
107075
—
AL
05
—
110572
—
AL
05
—
272792700
—
FL
Enumeration date
01/27/2006
Last updated
03/20/2018
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