Provider Demographics
NPI:1063585883
Name:BAITAN ENTERPRISES CO.
Entity type:Organization
Organization Name:BAITAN ENTERPRISES CO.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-814-6000
Mailing Address - Street 1:4023 TAMPA RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3212
Mailing Address - Country:US
Mailing Address - Phone:813-814-6000
Mailing Address - Fax:904-541-0333
Practice Address - Street 1:1199 W GRANADA BLVD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5912
Practice Address - Country:US
Practice Address - Phone:904-541-0222
Practice Address - Fax:904-541-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health