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General NPI Number Information
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NPI Number | 1861675787
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Entity Type | Organization
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Legal Business Name | BAY CENTRAL NEUROLOGY INC
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 2575 ULMERTON RD SUITE 300
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City | ST. PETERSBURG
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State | FL
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Zip | 33762-2283
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Country | US
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Telephone | 727-471-0324
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Fax | 727-471-0329
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Provider Business Mailing Address
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Address Line | 2575 ULMERTON RD SUITE 300
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City | ST. PETERSBURG
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State | FL
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Zip | 33762-2283
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Country | US
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Telephone | 727-471-0324
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Fax | 727-471-0329
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | SUSAN E UNGER
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Credential |
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Telephone | 727-471-0324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME85988
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License Number State | FL
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