Provider Demographics
NPI:1447260484
Name:DEAN, DAVID BAHMAN (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BAHMAN
Last Name:DEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2404 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-3943
Mailing Address - Country:US
Mailing Address - Phone:727-945-0100
Mailing Address - Fax:727-945-0133
Practice Address - Street 1:2404 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-3943
Practice Address - Country:US
Practice Address - Phone:727-945-0100
Practice Address - Fax:727-945-0133
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0078794207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine