Individual
ROBERT D. BAZLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3241 LAKELAND HILLS BLVD, LAKELAND, FL 33805-2266
(863) 413-2620
Mailing address
1290 GOLFVIEW AVE, ATTN: BILLING DEPARTMENT, BARTOW, FL 33830-6740
(863) 519-7900
(863) 519-7696
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
36355
MO
207V00000X
Obstetrics & Gynecology Physician
Primary
ME45747
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000046600
—
FL
01
—
119334
BLUE CROSS
—
01
—
160048858
RAILROAD
—
05
—
203990411
—
MO
01
—
68594
BCBS
FL
Enumeration date
08/21/2006
Last updated
06/23/2016
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