MEDICARE: BAY AREA PHYSICAL THERAPY 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	261QP2000X	Physical Therapy Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	650017363	OTHER	FL	RR MEDICARE UPIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27001	OTHER	FL	WELLCARE PROVIDER NUMBER
3	4011	OTHER	FL	STAYWELL PROVIDER NUMBER
4	Y909J	OTHER	FL	BCBS PROVIDER NUMBER
5	DA6508	OTHER	FL	MCR GROUP NUMBER
6	2288818	OTHER	FL	AETNA PROVIDER

General Provider Information

NPI Number	:	1871582742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	3657 CORTEZ RD W STE 110
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-3171
Country	:	US
Telephone Number	:	941-739-7828
Fax Number	:	941-739-7838

Provider Business Practice Location Address
First Line	:	3657 CORTEZ RD W
Second Line	:	SUITE 110
City	:	BRADENTON
State	:	FL
Zip	:	34210-3198
Country	:	US
Telephone Number	:	941-739-7828
Fax Number	:	941-739-7838

Authorized Official
Title or Position	:	COO
Name	:	MACKENZIE M BARTRUFF
Credential	:
Telephone Number	:	941-739-7828

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	04/09/2024

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Directions to “BAY AREA PHYSICAL THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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