Provider Demographics
NPI:1356747315
Name:BAYLIFE PHYSICAL THERAPY & REHABILITATION, INC.
Entity type:Organization
Organization Name:BAYLIFE PHYSICAL THERAPY & REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:727-520-0800
Mailing Address - Street 1:8950 DR MARTIN LUTHER KING JR ST N
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-3001
Mailing Address - Country:US
Mailing Address - Phone:727-520-0800
Mailing Address - Fax:727-520-0313
Practice Address - Street 1:9021 OAKHURST RD
Practice Address - Street 2:SUITE A & B
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33776-2156
Practice Address - Country:US
Practice Address - Phone:727-520-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3921Medicare UPIN