Healthcare Provider Details

I. General information

NPI: 1275671745
Provider Name (Legal Business Name): BAY AREA MEDICAL CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2007
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37900 DAUGHTERY RD
ZEPHYRHILLS FL
33541-1316
US

IV. Provider business mailing address

PO BOX 48589
TAMPA FL
33647-0122
US

V. Phone/Fax

Practice location:
  • Phone: 813-715-4446
  • Fax: 813-780-7786
Mailing address:
  • Phone: 813-715-4446
  • Fax: 813-780-7786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0070811
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME0041877
License Number StateFL

VIII. Authorized Official

Name: DR. SYED ALI SAFDAR
Title or Position: PRESIDENT
Credential:
Phone: 813-715-4446