Provider Demographics
NPI:1922481399
Name:BAYFRONT HEALTH
Entity Type:Organization
Organization Name:BAYFRONT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRAUMA PRACTITIONER ARNP
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-485-6179
Mailing Address - Street 1:603 7TH ST S
Mailing Address - Street 2:STE 500
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4719
Mailing Address - Country:US
Mailing Address - Phone:727-893-6254
Mailing Address - Fax:727-553-7158
Practice Address - Street 1:603 7TH ST S
Practice Address - Street 2:STE 500
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4719
Practice Address - Country:US
Practice Address - Phone:727-893-6254
Practice Address - Fax:727-553-7158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-03
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9288084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty