Baycare Medical Group INC
Family Medicine in Clearwater, FL. Organization (NPI-2).
NPI number1710550553
StatusActive
Last updated in NPPESJul 20, 2021
Details
- NPI
- 1710550553
- Entity type
- Organization (NPI-2)
- Legal business name
- Baycare Medical Group INC
- Organization subpart
- No
- Enumeration date
- Jul 20, 2021
- Certification date
- Jun 23, 2021
- Last updated
- Jul 20, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207R00000X | Internal Medicine | – | – |
Other names
- Countryside III (Other Name)
Practice location
3251 N Mcmullen Booth Rd Ste 103Clearwater, FL 33761-2022
Phone 727-799-6385 · Fax 727-635-7863
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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