Organization
DEREK BAZEMORE MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK GLENN BAZEMORE JR. MD (PRESIDENT)
(917) 750-5709
Entity
Organization
Contact information
Practice address
55 SW 9TH ST APT 1405, MIAMI, FL 33130-3992
(917) 750-5709
Mailing address
55 SW 9TH ST APT 1405, MIAMI, FL 33130-3992
(917) 750-5709
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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