Provider Demographics
NPI:1477211001
Name:BAZILME, BATRONY (PA)
Entity Type:Individual
Prefix:DR
First Name:BATRONY
Middle Name:
Last Name:BAZILME
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 SUMMIT BLVD UNIT 16601
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33416-4063
Mailing Address - Country:US
Mailing Address - Phone:561-410-8361
Mailing Address - Fax:
Practice Address - Street 1:1565 QUAIL LAKE DR
Practice Address - Street 2:APT F104
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:561-410-8361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1123-P.A.363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical