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NPI Code Detail

MEDICARE: BAY DERMATOLOGY AND COSMETIC SURGERY P A

MEDICARE: BAY DERMATOLOGY AND COSMETIC SURGERY P A
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
1207N00000XDermatology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437148996
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAY DERMATOLOGY AND COSMETIC SURGERY P A
Provider Business Mailing Address
First Line : 8220 US HIGHWAY 19
Second Line :
City : PORT RICHEY
State : FL
Zip : 34668-6639
Country : US
Telephone Number : 727-841-8505
Fax Number : 727-846-0561
Provider Business Practice Location Address
First Line : 8220 US HIGHWAY 19
Second Line :
City : PORT RICHEY
State : FL
Zip : 34668-6639
Country : US
Telephone Number : 727-841-8505
Fax Number : 727-846-0561
Authorized Official
Title or Position : CEO
Name : RICHARD A MILLER
Credential : DO
Telephone Number : 727-841-8505
Provider Enumeration Date : 10/18/2005
Last Update Date : 12/16/2024

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Directions to “BAY DERMATOLOGY AND COSMETIC SURGERY P A ” Practice Location

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