MEDICARE: BAY AREA INTERNIST INC

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	208D00000X	General Practice Physician	ME0088299	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1689885527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA INTERNIST INC

Provider Business Mailing Address
First Line	:	5520 DR MARTIN LUTHER KING JR ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33703-1204
Country	:	US
Telephone Number	:	727-526-1775
Fax Number	:	727-526-5764

Provider Business Practice Location Address
First Line	:	5520 DR MARTIN LUTHER KING JR ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33703-1204
Country	:	US
Telephone Number	:	727-526-1775
Fax Number	:	727-526-5764

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BHANUPRASAD PATEL
Credential	:
Telephone Number	:	727-526-1775

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	11/29/2012

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Directions to “BAY AREA INTERNIST INC ” Practice Location

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