MEDICARE: BAYOU ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES 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	367500000X	Certified Registered Nurse Anesthetist		FL
2	207L00000X	Anesthesiology Physician		FL
3	207LP2900X	Pain Medicine (Anesthesiology) Physician		FL
4	208VP0014X	Interventional Pain Medicine Physician	ME53592	FL
5	208VP0000X	Pain Medicine Physician	ME53592	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	34750	OTHER	FL	BCBSFL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801889522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYOU ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES PA

Provider Business Mailing Address
First Line	:	PO BOX 30130
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33630-3130
Country	:	US
Telephone Number	:	800-919-1190
Fax Number	:	706-860-7973

Provider Business Practice Location Address
First Line	:	6221 66TH ST
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-5025
Country	:	US
Telephone Number	:	727-545-8454
Fax Number	:	727-547-6983

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	DR. TODD STEVEN TRAUB
Credential	:	MD
Telephone Number	:	727-545-8454

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	07/21/2022

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Directions to “BAYOU ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES PA ” Practice Location

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