Provider Demographics
NPI:1720470255
Name:BAYER NEUROBEHAVIORAL CENTER, PLLC
Entity type:Organization
Organization Name:BAYER NEUROBEHAVIORAL CENTER, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAYER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:850-226-7666
Mailing Address - Street 1:3 VINE AVE NE
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32548-5069
Mailing Address - Country:US
Mailing Address - Phone:850-226-7666
Mailing Address - Fax:850-266-7499
Practice Address - Street 1:3 VINE AVE NE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-5069
Practice Address - Country:US
Practice Address - Phone:850-226-7666
Practice Address - Fax:850-266-7499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9214103G00000X
FLPY9440103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty