Provider Demographics
NPI:1801889522
Name:BAYOU ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES PA
Entity type:Organization
Organization Name:BAYOU ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:TRAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-545-8454
Mailing Address - Street 1:PO BOX 30130
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33630-3130
Mailing Address - Country:US
Mailing Address - Phone:800-919-1190
Mailing Address - Fax:706-860-7973
Practice Address - Street 1:6221 66TH ST
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-5025
Practice Address - Country:US
Practice Address - Phone:727-545-8454
Practice Address - Fax:727-547-6983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL367500000X, 207L00000X, 207LP2900X
FLME53592208VP0014X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267408400Medicaid
FL34750OtherBCBSFL
FL267408401Medicaid
FL267408402Medicaid
FLK4603Medicare PIN