DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. DEREK GLENN BAZEMORE JR., MD

Active Sole Proprietor

Family Medicine · MIAMI, FL

Registration Details

NPI Number
1639495245
Provider Type
Individual
Gender
Male
NPI Issued
Apr 8, 2010 (16.054287414331 yrs)
Last Updated
Jun 14, 2023
Licenses
ME107380 (FL)
ME107380 (FL)
ME107380 (FL)
Sole Proprietor
Yes

Practice Information

Address
12750 SW 128TH ST STE 108
MIAMI, FL, 331865380
Browse FL providers · Browse ZIP 33186
Phone
9177505709
Primary Specialty
Family Medicine
207Q00000X
Additional Specialty
General Practice
Additional Specialty
Family Medicine

Other Family Medicine Providers in MIAMI, FL

Name Credential NPI
DR. CLIFFORD A KINDER MD 1669476537
DR. GERARDO JORGE FRANCO D.O. 1942208582
DR. NORMA SALENAH LAKE MD 1912906686
DR. CARLOS MIGUEL LAROCCA M.D. 1265424097
DR. ONEL CORRALES M.D. 1447246681
NANCY MARIE EKLUND MD 1942298435
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.