Provider Demographics
NPI:1992414684
Name:BODY BY BARIATRICS, LLC
Entity type:Organization
Organization Name:BODY BY BARIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/BARIATRIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DOVEC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-374-3584
Mailing Address - Street 1:7512 DR PHILLIPS BLVD STE 50-792
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5420
Mailing Address - Country:US
Mailing Address - Phone:304-374-3584
Mailing Address - Fax:
Practice Address - Street 1:3030 HARDEN BLVD BLDG 1
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-7952
Practice Address - Country:US
Practice Address - Phone:304-374-3584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty