Healthcare Provider Details

I. General information

NPI: 1609364652
Provider Name (Legal Business Name): SEMERJIT SINGH BAINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 5TH ST S
ST PETERSBURG FL
33701-4804
US

IV. Provider business mailing address

601 5TH ST S
ST PETERSBURG FL
33701-4804
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-3679
  • Fax:
Mailing address:
  • Phone: 786-768-1056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME0169955
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: