Provider Demographics
NPI:1740694942
Name:BAY DERMATOLOGY & COSMETIC SURGERY, P.A.
Entity type:Organization
Organization Name:BAY DERMATOLOGY & COSMETIC SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SULTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-266-3242
Mailing Address - Street 1:4683 CHABOT DR STE 200
Mailing Address - Street 2:C/O ADVANCED RX MANAGEMENT
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3829
Mailing Address - Country:US
Mailing Address - Phone:925-621-2900
Mailing Address - Fax:925-522-2930
Practice Address - Street 1:7500 GULF BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:ST PETE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33706-1821
Practice Address - Country:US
Practice Address - Phone:727-258-0625
Practice Address - Fax:727-360-1680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site