Bay Area Mobile Clinic LLC
Clinic/Center in Dade City, FL. Organization (NPI-2).
NPI number1235637398
StatusActive
Last updated in NPPESMar 30, 2021
Details
- NPI
- 1235637398
- Entity type
- Organization (NPI-2)
- Legal business name
- Bay Area Mobile Clinic LLC
- Organization subpart
- No
- Enumeration date
- Jan 24, 2018
- Certification date
- Mar 30, 2021
- Last updated
- Mar 30, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
15000 Citrus Country Dr # 414Dade City, FL 33523-6014
Phone 813-924-8911
Mailing address
15000 Citrus Country Dr # 414Dade City, FL 33523-6014
Other practice locations
7715 Bulls Head Dr
Wesley Chapel, FL 33545-7049
Wesley Chapel, FL 33545-7049
Phone 813-924-8911
Authorized official
Junise Belizaire
Owner
8139248911
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All 5 Clinic/Center providers in Dade City · All 505 providers in Dade City
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