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General NPI Number Information
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NPI Number | 1053883041
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Entity Type | Individual
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Provider Name | SUTHIDA BAYRASY
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Gender | Female
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Dates
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Enumeration Date | 01/01/2019
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Last Update Date | 07/13/2025
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Provider Practice Location Address
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Address Line | 3801 CORPOREX PARK DR STE 115
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City | TAMPA
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State | FL
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Zip | 33619-1179
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Country | US
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Telephone | 727-803-0023
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Fax |
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Provider Business Mailing Address
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Address Line | 306 S WESTLAND AVE APT 1
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City | TAMPA
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State | FL
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Zip | 33606-1802
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Country | US
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Telephone | 727-600-0984
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 37842
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | PS62989
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License Number State | FL
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