Provider Demographics
NPI:1437185881
Name:BAY PINES HEATLH CARE SYSTEM
Entity Type:Organization
Organization Name:BAY PINES HEATLH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-734-5276
Mailing Address - Street 1:10000 BAY PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:BAY PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33774-6402
Mailing Address - Country:US
Mailing Address - Phone:727-398-6661
Mailing Address - Fax:727-734-5914
Practice Address - Street 1:1721 MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-6402
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-734-5914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0S-7578261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center