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General NPI Number Information
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NPI Number | 1689885527
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Entity Type | Organization
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Legal Business Name | BAY AREA INTERNIST INC
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 11/29/2012
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Provider Practice Location Address
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Address Line | 5520 DR MARTIN LUTHER KING JR ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33703-1204
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Country | US
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Telephone | 727-526-1775
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Fax | 727-526-5764
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Provider Business Mailing Address
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Address Line | 5520 DR MARTIN LUTHER KING JR ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33703-1204
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Country | US
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Telephone | 727-526-1775
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Fax | 727-526-5764
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Authorized Official
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Title or Position | PRESIDENT
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Name | BHANUPRASAD PATEL
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Credential |
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Telephone | 727-526-1775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME0088299
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License Number State | FL
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