Healthcare Provider Details

I. General information

NPI: 1205887247
Provider Name (Legal Business Name): BAYCARE ANESTHESIA ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7050 GALL BLVD
ZEPHYRHILLS FL
33541-1347
US

IV. Provider business mailing address

PO BOX 550307
TAMPA FL
33655-0307
US

V. Phone/Fax

Practice location:
  • Phone: 352-867-8898
  • Fax: 352-732-6282
Mailing address:
  • Phone: 352-867-8898
  • Fax: 352-732-6282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: MRS. PAULA BELLINO
Title or Position: PRESIDENT
Credential: CRNA
Phone: 352-867-8898