| Baycare Medical Group Inc | |
|
1201 5th Ave N Ste 309 St Petersburg FL 33705-1425 | |
| (727) 824-3189 | |
| (727) 824-7101 |
| Full Name | Baycare Medical Group Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1201 5th Ave N Ste 309, St Petersburg, Florida |
| Authorized Official Name and Position | Lynda Gorken (VP, PFS) |
| Authorized Official Contact | 7272819202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baycare Medical Group Inc 2995 Drew St Fl 3 Clearwater FL 33759-3012 Ph: () - | Baycare Medical Group Inc 1201 5th Ave N Ste 309 St Petersburg FL 33705-1425 Ph: (727) 824-3189 |
| NPI Number | 1275103624 |
|---|---|
| Provider Enumeration Date | 06/29/2021 |
| Last Update Date | 06/29/2021 |
| Certification Date | 06/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275103624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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