Provider Demographics
NPI:1679575542
Name:BOBET, MYRNA (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRNA
Middle Name:
Last Name:BOBET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 NORTH PALAFOX STREET
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501
Mailing Address - Country:US
Mailing Address - Phone:850-434-5033
Mailing Address - Fax:850-433-0268
Practice Address - Street 1:1120 NORTH PALAFOX STREET
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501
Practice Address - Country:US
Practice Address - Phone:850-434-5033
Practice Address - Fax:850-433-0268
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000251952084P0800X
FLME1087042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL331634583Medicaid
AL331600583Medicaid
AL331634583Medicaid
AL51515262Medicare ID - Type Unspecified