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General NPI Number Information
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NPI Number | 1487196440
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Entity Type | Organization
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Legal Business Name | BAYCARE URGENT CARE, LLC
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Dates
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Enumeration Date | 11/08/2016
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 36245 HWY 27
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City | HAINES CITY
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State | FL
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Zip | 33844-3744
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Country | US
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Telephone | 863-866-9933
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Fax | 863-229-7556
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Provider Business Mailing Address
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Address Line | 2995 DREW STREET EAST BLDG 2ND FLOOR
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City | CLEARWATER
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State | FL
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Zip | 33759
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Country | US
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Telephone | 727-281-9390
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Fax | 813-635-2613
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Authorized Official
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Title or Position | VP, PFS
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Name | LYNDA A GORKEN
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Credential |
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Telephone | 727-281-9390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | ME58834
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License Number State | FL
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