Provider Demographics
NPI:1275741803
Name:A- BAY AREA MEDICAL CLINICS PA
Entity Type:Organization
Organization Name:A- BAY AREA MEDICAL CLINICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:C
Authorized Official - Last Name:LARACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-515-6968
Mailing Address - Street 1:202 HANCOCK CT
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-3723
Mailing Address - Country:US
Mailing Address - Phone:727-327-0879
Mailing Address - Fax:727-724-9720
Practice Address - Street 1:202 HANCOCK CT
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-3723
Practice Address - Country:US
Practice Address - Phone:727-327-0879
Practice Address - Fax:727-724-9720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42951207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty