| Bayside Family Healthcare Clearwater, Llc | |
|
107 N Mcmullen Booth Rd Clearwater FL 33759-4450 | |
| (727) 504-7073 | |
| (813) 200-3313 |
| Full Name | Bayside Family Healthcare Clearwater, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 107 N Mcmullen Booth Rd, Clearwater, Florida |
| Authorized Official Name and Position | Patrick E Hickey (MGRM) |
| Authorized Official Contact | 7275047073 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayside Family Healthcare Clearwater, Llc 107 N Mcmullen Booth Rd Clearwater FL 33759-4450 Ph: (727) 504-7073 | Bayside Family Healthcare Clearwater, Llc 107 N Mcmullen Booth Rd Clearwater FL 33759-4450 Ph: (727) 504-7073 |
| NPI Number | 1760791859 |
|---|---|
| Provider Enumeration Date | 10/06/2010 |
| Last Update Date | 10/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760791859 | NPI | - | NPPES |
| 274541100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME85120 (Florida) | Primary |
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