MEDICARE: GULF BAY CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	HCC10872	FL
2	261QR0400X	Rehabilitation Clinic/Center	MM36223	FL
3	261QP2000X	Physical Therapy Clinic/Center	MM36223	FL

General Provider Information

NPI Number	:	1275051542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GULF BAY CARE LLC

Provider Business Mailing Address
First Line	:	8019 N HIMES AVE STE 311
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-2761
Country	:	US
Telephone Number	:	813-405-4428
Fax Number	:	813-405-4599

Provider Business Practice Location Address
First Line	:	8019 N HIMES AVE STE 311
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-2761
Country	:	US
Telephone Number	:	813-405-4428
Fax Number	:	813-405-4599

Authorized Official
Title or Position	:	OWNER
Name	:	YUNIER RODRIGUEZ
Credential	:
Telephone Number	:	813-405-4428

Provider Enumeration Date	:	09/06/2017
Last Update Date	:	07/21/2022

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Directions to “GULF BAY CARE LLC ” Practice Location

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