Provider Demographics
NPI:1760147532
Name:BAY AREA WELLNESS & HEALTHCARE, INC
Entity Type:Organization
Organization Name:BAY AREA WELLNESS & HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:JONIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-200-0980
Mailing Address - Street 1:3600 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8407
Mailing Address - Country:US
Mailing Address - Phone:727-327-4522
Mailing Address - Fax:727-327-8069
Practice Address - Street 1:3600 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8407
Practice Address - Country:US
Practice Address - Phone:727-327-4522
Practice Address - Fax:727-327-8069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-05
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty