Provider Demographics
NPI:1073549432
Name:BAY AREA SURGICAL ASSO
Entity Type:Organization
Organization Name:BAY AREA SURGICAL ASSO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-822-0442
Mailing Address - Street 1:603 - 7TH ST SO
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4734
Mailing Address - Country:US
Mailing Address - Phone:727-822-0442
Mailing Address - Fax:727-821-0416
Practice Address - Street 1:603 - 7TH ST SO
Practice Address - Street 2:SUITE 500
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4734
Practice Address - Country:US
Practice Address - Phone:727-822-0442
Practice Address - Fax:727-821-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376412500Medicaid
72937Medicare ID - Type UnspecifiedSPECIALTY CODE 02