MEDICARE: BAY AREA IPA SERVICES LLC

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	177F00000X	Lodging Provider

General Provider Information

NPI Number	:	1841092541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA IPA SERVICES LLC

Provider Business Mailing Address
First Line	:	6328 GUNN HWY STE B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-4101
Country	:	US
Telephone Number	:	813-964-8526
Fax Number	:	813-964-8536

Provider Business Practice Location Address
First Line	:	6328 GUNN HWY STE B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-4101
Country	:	US
Telephone Number	:	813-964-8526
Fax Number	:	813-964-8536

Authorized Official
Title or Position	:	OWNER
Name	:	SHITAL MEHTA
Credential	:	DO
Telephone Number	:	813-964-8526

Provider Enumeration Date	:	03/25/2025
Last Update Date	:	03/25/2025

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Directions to “BAY AREA IPA SERVICES LLC ” Practice Location

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