MEDICARE: BAY PEDIATRICS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	ME71848	FL

General Provider Information

NPI Number	:	1033509062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY PEDIATRICS PA

Provider Business Mailing Address
First Line	:	1725 E BAY DR
Second Line	:	SUITE A
City	:	LARGO
State	:	FL
Zip	:	33771-2208
Country	:	US
Telephone Number	:	727-584-9810
Fax Number	:	727-584-9812

Provider Business Practice Location Address
First Line	:	1725 E BAY DR
Second Line	:	SUITE A
City	:	LARGO
State	:	FL
Zip	:	33771-2208
Country	:	US
Telephone Number	:	727-584-9810
Fax Number	:	727-584-9812

Authorized Official
Title or Position	:	PHYSICIAN/PRESIDENT
Name	:	DR. TIMOTHY JOSEPH VAUGHAN
Credential	:	M.D.
Telephone Number	:	727-584-9810

Provider Enumeration Date	:	01/29/2015
Last Update Date	:	01/29/2015

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Directions to “BAY PEDIATRICS PA ” Practice Location

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