Individual
MIHO KOJIMA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1601 SW ARCHER RD, GAINESVILLE, FL 32608-1135
(352) 374-1611
Mailing address
1601 SW ARCHER RD, GRECC (182), GAINESVILLE, FL 32608-1135
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME 091654
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
ME91654
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273482600
—
FL
Enumeration date
06/07/2006
Last updated
10/17/2010
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