Healthcare Provider Details

I. General information

NPI: 1972584829
Provider Name (Legal Business Name): BAY AREA CHEST PHYSICIANS P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 05/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 MORTON PLANT STREET SUITE 405
CLEARWATER FL
33756-3394
US

IV. Provider business mailing address

430 MORTON PLANT STREET SUITE 405
CLEARWATER FL
33756-3394
US

V. Phone/Fax

Practice location:
  • Phone: 727-443-0611
  • Fax: 727-461-5493
Mailing address:
  • Phone: 727-443-0611
  • Fax: 727-461-5493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: TODD BURCH
Title or Position: PRACTICE ADMIN
Credential:
Phone: 727-443-0611