Provider Demographics
NPI:1407035645
Name:BAY IMAGING CORPORATION
Entity Type:Organization
Organization Name:BAY IMAGING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-795-9729
Mailing Address - Street 1:627 BRIGHTWATERS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-3715
Mailing Address - Country:US
Mailing Address - Phone:352-795-9729
Mailing Address - Fax:352-795-9262
Practice Address - Street 1:627 BRIGHTWATERS BLVD NE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-3715
Practice Address - Country:US
Practice Address - Phone:352-795-9729
Practice Address - Fax:352-795-9262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00372302085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04548OtherBCBS
FLK4908Medicare PIN