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NPI Code Detail

MEDICARE: BAYCARE MEDICAL GROUP INC

MEDICARE: BAYCARE MEDICAL GROUP INC
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
1207R00000XInternal Medicine Physician
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1124697180
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAYCARE MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 2995 DREW ST FL 3
Second Line :
City : CLEARWATER
State : FL
Zip : 33759-3012
Country : US
Telephone Number : 727-281-9390
Fax Number :
Provider Business Practice Location Address
First Line : 711 S BELCHER RD
Second Line :
City : CLEARWATER
State : FL
Zip : 33764-6326
Country : US
Telephone Number : 813-443-8070
Fax Number :
Authorized Official
Title or Position : VP, PFS
Name : LYNDA GORKEN
Credential :
Telephone Number : 727-281-9202
Provider Enumeration Date : 06/23/2021
Last Update Date : 06/23/2021

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Directions to “BAYCARE MEDICAL GROUP INC ” Practice Location

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