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Individual

DR. MELISSA BAHAREH BAGLOO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1925 MIZELL AVE STE 201, WINTER PARK, FL 32792-4155
(407) 303-7399
Mailing address
1925 MIZELL AVE STE 201, WINTER PARK, FL 32792-4155
(407) 303-7399

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
246679-1
NY
208600000X
Surgery Physician
25MA08805600
NJ
208600000X
Surgery Physician
Primary
ME146371
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03112663
NY
Enumeration date
06/16/2008
Last updated
04/20/2022
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