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Individual

BROOKE C. BAVINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3001 W DR MLK BLVD, TAMPA, FL 33607-6307
(813) 554-8094
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
(813) 974-2201

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME116654
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010213300
FL
Enumeration date
06/08/2010
Last updated
08/12/2016
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