Most Relevant Information
Provider Data
| NPI Number: | 1003011735 |
| Provider Name: | BAHAREH EBADIFAR KEITH DO |
| Entity Type: | Individual |
| Taxonomy Code: | 208000000X |
| Specialty: | Pediatrics |
| License Number: | UO1652 |
Most Important Dates
| Enumeration Date: | 06/21/2007 |
| Last Updated: | 09/24/2010 |
Provider Practice Location
1600 SW ARCHER RD
GAINESVILLE
FL
326103003
Practice Location Phone/Fax
| Phone: | 3522730462 |
| Fax: | 3522736250 |
Provider Mailing Location
PO BOX 918025
ORLANDO
FL
328918025
Provider Mailing Phone/Fax
| Phone: | 3522730462 |
| Fax: | 3522736250 |
Suggested EMR
Pediatrics EMR