Provider Demographics
NPI:1740619634
Name:BAY POINT MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:BAY POINT MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-325-0809
Mailing Address - Street 1:4770 BISCAYNE BOULEVARD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137
Mailing Address - Country:US
Mailing Address - Phone:305-325-0809
Mailing Address - Fax:305-456-3509
Practice Address - Street 1:4770 BISCAYNE BOULEVARD
Practice Address - Street 2:SUITE 150
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137
Practice Address - Country:US
Practice Address - Phone:305-325-0809
Practice Address - Fax:305-456-3509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL96104146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty