Healthcare Provider Details

I. General information

NPI: 1932617529
Provider Name (Legal Business Name): BAY AREA ORTHOPAEDIC SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 PARK BLVD N
PINELLAS PARK FL
33781-3534
US

IV. Provider business mailing address

1745 OYSTER POINT WAY
PALM HARBOR FL
34683-3431
US

V. Phone/Fax

Practice location:
  • Phone: 727-401-4529
  • Fax: 727-499-7181
Mailing address:
  • Phone: 727-209-6677
  • Fax: 727-499-7181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberME117110
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberME117110
License Number StateFL

VIII. Authorized Official

Name: DR. DAVID TIMOTHY BRAUN
Title or Position: OWNER
Credential: MD, MBA
Phone: 267-259-5451