Provider Demographics
NPI:1932617529
Name:BAY AREA ORTHOPAEDIC SPECIALISTS LLC
Entity Type:Organization
Organization Name:BAY AREA ORTHOPAEDIC SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:267-259-5451
Mailing Address - Street 1:1745 OYSTER POINT WAY
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-3431
Mailing Address - Country:US
Mailing Address - Phone:727-209-6677
Mailing Address - Fax:727-499-7181
Practice Address - Street 1:4820 PARK BLVD N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3534
Practice Address - Country:US
Practice Address - Phone:727-401-4529
Practice Address - Fax:727-499-7181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117110207XX0801X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Single Specialty