Individual
JOHN BACHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2221 SE OCEAN BLVD, STE 200, STUART, FL 34996-3341
(772) 219-4026
(772) 223-4919
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-5665
(772) 223-5646
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
5101017517
MI
208600000X
Surgery Physician
Primary
OS11728
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005925800
—
FL
01
—
14LT1
BCBS
FL
Enumeration date
08/10/2007
Last updated
11/14/2012
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