Provider Demographics
NPI:1316907074
Name:BAYER, MARCIA J (ARNP)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:J
Last Name:BAYER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:J
Other - Last Name:WERNER BAYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:695 N CLYDE MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2321
Mailing Address - Country:US
Mailing Address - Phone:386-258-8722
Mailing Address - Fax:386-258-8659
Practice Address - Street 1:695 N CLYDE MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2321
Practice Address - Country:US
Practice Address - Phone:386-258-8722
Practice Address - Fax:386-258-8659
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1656612363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S99145Medicare UPIN
E3622ZMedicare ID - Type Unspecified