Provider Demographics
NPI:1043109630
Name:LE, BACH SON (PA)
Entity type:Individual
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First Name:BACH
Middle Name:SON
Last Name:LE
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Gender:M
Credentials:PA
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Mailing Address - Street 1:2902 59TH ST W STE C
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7021
Mailing Address - Country:US
Mailing Address - Phone:941-877-7000
Mailing Address - Fax:941-877-7000
Practice Address - Street 1:2902 59TH ST W STE C
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7021
Practice Address - Country:US
Practice Address - Phone:941-877-7000
Practice Address - Fax:941-877-7000
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-07-14
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant