Provider Demographics
NPI:1407287444
Name:BAY AREA HEALTHCARE, INC.
Entity Type:Organization
Organization Name:BAY AREA HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:727-327-4522
Mailing Address - Street 1:3600 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8407
Mailing Address - Country:US
Mailing Address - Phone:727-327-4522
Mailing Address - Fax:727-327-8069
Practice Address - Street 1:3600 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8407
Practice Address - Country:US
Practice Address - Phone:727-327-4522
Practice Address - Fax:727-327-8069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9322426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty