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General NPI Number Information
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NPI Number | 1962436683
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Entity Type | Organization
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Legal Business Name | BAY PINES VA HEALTH CARE SYSTEM
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10,000 BAY PINES BLVD
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City | BAY PINES
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State | FL
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Zip | 33744
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Country | US
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Telephone | 727-398-6661
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Fax | 727-398-9549
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Provider Business Mailing Address
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Address Line | 895 ADDISON DR NE
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City | ST PETERSBURG
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State | FL
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Zip | 33716-3443
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Country | US
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Telephone | 727-570-9727
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Fax | 727-398-9549
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Authorized Official
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Title or Position | CHIEF OF STAFF
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Name | DR. GEORGE F VAN BUSKIRK
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Credential | MD
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Telephone | 727-398-6661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | ME 67702
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License Number State | FL
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