Provider Demographics
NPI:1760022495
Name:BACIN, LYUBA (RN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:LYUBA
Middle Name:
Last Name:BACIN
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 SE 1ST AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0478
Mailing Address - Country:US
Mailing Address - Phone:352-237-9298
Mailing Address - Fax:352-351-4193
Practice Address - Street 1:2801 SE 1ST AVE STE 302
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0478
Practice Address - Country:US
Practice Address - Phone:352-237-9298
Practice Address - Fax:352-351-4193
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1005637363LP2300X
FLAPRN11005637363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty