Provider Demographics
NPI:1538578828
Name:BAYFRONT HEALTH
Entity type:Organization
Organization Name:BAYFRONT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:RAYE
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-C
Authorized Official - Phone:727-804-6766
Mailing Address - Street 1:10263 GANDY BLVD N
Mailing Address - Street 2:APT 2407
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2389
Mailing Address - Country:US
Mailing Address - Phone:727-804-6766
Mailing Address - Fax:
Practice Address - Street 1:7000 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5903
Practice Address - Country:US
Practice Address - Phone:727-823-4848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9309591363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty