Healthcare Provider Details

I. General information

NPI: 1174932743
Provider Name (Legal Business Name): DARRYL B BAIN ARNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2014
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6633 FOREST AVE STE 300
NEW PORT RICHEY FL
34653-2612
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 727-724-8611
  • Fax: 727-724-0425
Mailing address:
  • Phone: 727-483-1323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN9232011
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: