Healthcare Provider Details

I. General information

NPI: 1396912663
Provider Name (Legal Business Name): BAYAREAREHABILITATIONCENTER,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7219 BENJAMIN RD UNIT D
TAMPA FL
33634-3012
US

IV. Provider business mailing address

7219 BENJAMIN RD UNIT D
TAMPA FL
33634-3012
US

V. Phone/Fax

Practice location:
  • Phone: 813-888-7044
  • Fax: 813-888-8081
Mailing address:
  • Phone: 813-888-7044
  • Fax: 813-888-8081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberCH8326
License Number StateFL

VIII. Authorized Official

Name: DR. ANTHONY P ESPOSITO
Title or Position: OWNER/PHYSICIAN
Credential: DC
Phone: 813-888-7044