Healthcare Provider Details

I. General information

NPI: 1497765374
Provider Name (Legal Business Name): BAPTIST ESTATES OF FLORIDA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 BAY AVE
CLEARWATER FL
33756-5291
US

IV. Provider business mailing address

420 BAY AVE
CLEARWATER FL
33756-5291
US

V. Phone/Fax

Practice location:
  • Phone: 727-445-4700
  • Fax: 727-462-9902
Mailing address:
  • Phone: 727-445-4700
  • Fax: 727-462-9902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1374096
License Number StateFL

VIII. Authorized Official

Name: MR. DAVID G GERY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 727-445-4700