Provider Demographics
NPI:1013379957
Name:BAI MEDICAL LLC
Entity Type:Organization
Organization Name:BAI MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BELMAR
Authorized Official - Middle Name:IRIZARRY
Authorized Official - Last Name:GARCES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-242-2279
Mailing Address - Street 1:580 LEXINGTON GREEN LANE
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771
Mailing Address - Country:US
Mailing Address - Phone:787-242-2279
Mailing Address - Fax:
Practice Address - Street 1:580 LEXINGTON GREEN LANE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771
Practice Address - Country:US
Practice Address - Phone:787-242-2279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-21
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME120944305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1750679379Medicare NSC