Provider Demographics
NPI:1386609899
Name:BITAR, REMBERTO JOSE (MD)
Entity type:Individual
Prefix:
First Name:REMBERTO
Middle Name:JOSE
Last Name:BITAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9848 SLOANE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7052
Mailing Address - Country:US
Mailing Address - Phone:434-272-9180
Mailing Address - Fax:
Practice Address - Street 1:1121 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4405
Practice Address - Country:US
Practice Address - Phone:407-933-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT144324207RC0200X
FLME67365207RP1001X
TXT4123207RP1001X
UT13961187-1235207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5293297OtherAETNA
FL206277OtherAVMED PROVIDER ID
FL250538000Medicaid
FL31614OtherBLUE CROSS BLUE SHIELD
FL4800321OtherUHC PROVIDER ID
FL9442230013OtherCIGNA PROVIDER ID
FL31614BMedicare ID - Type Unspecified
FL9442230013OtherCIGNA PROVIDER ID