Provider Demographics
NPI:1104364397
Name:BAYCARE HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:BAYCARE HEALTH SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YAZMIN
Authorized Official - Middle Name:MAGNOLIA
Authorized Official - Last Name:MORA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:863-279-9742
Mailing Address - Street 1:201 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3204
Mailing Address - Country:US
Mailing Address - Phone:863-294-7062
Mailing Address - Fax:
Practice Address - Street 1:201 1ST ST S
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3204
Practice Address - Country:US
Practice Address - Phone:863-294-7062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM080282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital