Provider Demographics
NPI:1588203905
Name:PAZ, BERNARD KABIGTING (NP-C)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:KABIGTING
Last Name:PAZ
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 THORNBURY LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-8419
Mailing Address - Country:US
Mailing Address - Phone:407-729-5422
Mailing Address - Fax:
Practice Address - Street 1:108 THORNBURY LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-8419
Practice Address - Country:US
Practice Address - Phone:407-729-5422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAG12190041363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty