Provider Demographics
NPI:1457348237
Name:BAY SURGICAL SPECIALISTS, LLC
Entity type:Organization
Organization Name:BAY SURGICAL SPECIALISTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JADE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-821-8101
Mailing Address - Street 1:960 7TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1347
Mailing Address - Country:US
Mailing Address - Phone:727-821-8101
Mailing Address - Fax:727-894-8360
Practice Address - Street 1:960 7TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1347
Practice Address - Country:US
Practice Address - Phone:727-821-8101
Practice Address - Fax:727-894-8360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267796200Medicaid
FLE75895Medicare UPIN
FLK4116Medicare ID - Type Unspecified