Individual
ALBAN BERKLEY BACCHUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2889 10TH AVE N, SUITE 301, PALM SPRINGS, FL 33461-3045
(561) 966-2303
(561) 966-0714
Mailing address
2889 10TH AVE N, SUITE 301, PALM SPRINGS, FL 33461-3045
(561) 966-2303
(561) 966-0714
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0054352
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063148500
—
FL
Enumeration date
10/18/2007
Last updated
10/18/2007
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