MEDICARE: BAY INJURY & REHAB 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
1	111N00000X	Chiropractor	CH9191	FL

General Provider Information

NPI Number	:	1225262082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY INJURY & REHAB INC

Provider Business Mailing Address
First Line	:	4800 4TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33703-3817
Country	:	US
Telephone Number	:	727-528-1133
Fax Number	:	727-527-3750

Provider Business Practice Location Address
First Line	:	4800 4TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33703-3817
Country	:	US
Telephone Number	:	727-528-1133
Fax Number	:	727-527-3750

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. SAMUEL ROBERT MEYERS
Credential	:	D.C.
Telephone Number	:	727-528-1133

Provider Enumeration Date	:	05/08/2009
Last Update Date	:	10/20/2011

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