Healthcare Provider Details

I. General information

NPI: 1164459095
Provider Name (Legal Business Name): BAY AREA EMERGENCY PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PINELLAS ST
CLEARWATER FL
33756-3804
US

IV. Provider business mailing address

PO BOX 17308
CLEARWATER FL
33762-0308
US

V. Phone/Fax

Practice location:
  • Phone: 727-461-8537
  • Fax:
Mailing address:
  • Phone: 904-482-1070
  • Fax: 904-482-1077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN HAIRE
Title or Position: PRESIDENT
Credential: MD
Phone: 727-461-8537