Provider Demographics
NPI:1831180744
Name:BAYONET POINT/HUDSON CARDIOLOGY ASSOCIATES
Entity type:Organization
Organization Name:BAYONET POINT/HUDSON CARDIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:S. K. RAO
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSUNURU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-862-1080
Mailing Address - Street 1:14100 FIVAY RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7180
Mailing Address - Country:US
Mailing Address - Phone:727-862-1080
Mailing Address - Fax:727-863-3093
Practice Address - Street 1:14100 FIVAY RD
Practice Address - Street 2:SUITE 160
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7180
Practice Address - Country:US
Practice Address - Phone:727-862-1080
Practice Address - Fax:727-863-3093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252929700Medicaid