Provider Demographics
NPI:1841200094
Name:BAY PHARMACOKINETIC ASSOCIATES LLC
Entity Type:Organization
Organization Name:BAY PHARMACOKINETIC ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:DEANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-392-1246
Mailing Address - Street 1:PO BOX 15759
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32406-5759
Mailing Address - Country:US
Mailing Address - Phone:850-392-1246
Mailing Address - Fax:850-763-1877
Practice Address - Street 1:760 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4003
Practice Address - Country:US
Practice Address - Phone:850-392-1246
Practice Address - Fax:850-763-1877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94787OtherBLUE CROSS BLUE SHIELD
FL272136800Medicaid
FLDD1599Medicare PIN
FL94787Medicare PIN