Provider Demographics
NPI:1205028198
Name:BAY MEDICAL CENTER OF TAMPA, P.A.
Entity Type:Organization
Organization Name:BAY MEDICAL CENTER OF TAMPA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-885-4706
Mailing Address - Street 1:7550 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3226
Mailing Address - Country:US
Mailing Address - Phone:813-885-4706
Mailing Address - Fax:813-885-9463
Practice Address - Street 1:7550 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3226
Practice Address - Country:US
Practice Address - Phone:813-885-4706
Practice Address - Fax:813-885-9463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME25828207Q00000X
FLPA 9101885363A00000X
FLPA 9101889363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty