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General NPI Number Information
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NPI Number | 1659016509
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Entity Type | Organization
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Legal Business Name | BAYWEST MEDICAL, LLC
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 5633 STATE ROAD 54
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-6020
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Country | US
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Telephone | 727-372-0091
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Fax | 727-372-0192
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Provider Business Mailing Address
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Address Line | 5633 STATE ROAD 54
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-6020
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Country | US
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Telephone | 727-372-0091
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Fax | 727-372-0192
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | JENIFER MCCOWAN
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Credential |
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Telephone | 727-372-0091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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