Provider Demographics
NPI:1417641911
Name:MARASIGAN, BAYANI OLIVER JR (APRN)
Entity Type:Individual
Prefix:
First Name:BAYANI
Middle Name:OLIVER
Last Name:MARASIGAN
Suffix:JR
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 MEDICAL CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5463
Mailing Address - Country:US
Mailing Address - Phone:863-314-0004
Mailing Address - Fax:863-304-8284
Practice Address - Street 1:130 MEDICAL CENTER AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5463
Practice Address - Country:US
Practice Address - Phone:863-314-0004
Practice Address - Fax:863-304-8284
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily