Provider Demographics
NPI:1417286154
Name:BAYFRONT MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:BAYFRONT MEDICAL CENTER, INC.
Other - Org Name:BAYFRONT BREAST HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:W
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-823-1234
Mailing Address - Street 1:603 7TH ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4719
Mailing Address - Country:US
Mailing Address - Phone:727-823-1234
Mailing Address - Fax:
Practice Address - Street 1:603 7TH ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701
Practice Address - Country:US
Practice Address - Phone:727-823-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYFRONT MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-09
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty