Provider Demographics
NPI:1649679341
Name:BAYONET POINT MEDICAL, LLC
Entity type:Organization
Organization Name:BAYONET POINT MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:ETAPU
Authorized Official - Last Name:ALINGU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-596-0405
Mailing Address - Street 1:10045 CORTEZ BLVD
Mailing Address - Street 2:STE. 122
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-6319
Mailing Address - Country:US
Mailing Address - Phone:727-869-1900
Mailing Address - Fax:352-597-4008
Practice Address - Street 1:7537 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6502
Practice Address - Country:US
Practice Address - Phone:727-869-1900
Practice Address - Fax:352-597-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77939261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care