MEDICARE: BAY POINT HEALTHCARE 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	261QP2400X	Prison Health Clinic/Center

General Provider Information

NPI Number	:	1649042615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY POINT HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	1016 THOMAS DR UNIT 262
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32408-7444
Country	:	US
Telephone Number	:	850-708-7059
Fax Number	:

Provider Business Practice Location Address
First Line	:	12216 PANAMA CITY BEACH PKWY STE D
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32407-2728
Country	:	US
Telephone Number	:	850-708-7059
Fax Number	:

Authorized Official
Title or Position	:	CEO/CMO
Name	:	BRUCE ALLEN WOODFORD
Credential	:	DO
Telephone Number	:	850-708-7059

Provider Enumeration Date	:	10/24/2023
Last Update Date	:	10/24/2023

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Directions to “BAY POINT HEALTHCARE LLC ” Practice Location

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