Baycare Medical Group INC
Family Medicine in St Petersburg, FL. Organization (NPI-2).
NPI number1164091138
StatusActive
Last updated in NPPESJun 23, 2021
Details
- NPI
- 1164091138
- Entity type
- Organization (NPI-2)
- Legal business name
- Baycare Medical Group INC
- Organization subpart
- No
- Enumeration date
- Jun 23, 2021
- Certification date
- Jun 23, 2021
- Last updated
- Jun 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207R00000X | Internal Medicine | – | – |
Other names
- Carillon Family Care (Other Name)
Practice location
900 Carillon Pkwy Ste 308St Petersburg, FL 33716-1120
Phone 727-561-2600 · Fax 727-333-6071
Mailing address
2995 Drew St Fl 3Clearwater, FL 33759-3012
Phone 727-281-9390
Authorized official
Lynda Gorken
Vp, Pfs
7272819202
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