Provider Demographics
NPI:1508033044
Name:BAYWEST HEALTH AND REHAB LLC
Entity Type:Organization
Organization Name:BAYWEST HEALTH AND REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-372-0091
Mailing Address - Street 1:5633 STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-6020
Mailing Address - Country:US
Mailing Address - Phone:727-372-0091
Mailing Address - Fax:727-372-0192
Practice Address - Street 1:5633 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-6020
Practice Address - Country:US
Practice Address - Phone:727-372-0091
Practice Address - Fax:727-372-0192
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYWEST HEALTH AND REHAB LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty