Provider Demographics
NPI:1588992341
Name:GULF BAY MEDICAL CENTER, INC
Entity type:Organization
Organization Name:GULF BAY MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HEARIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-443-4724
Mailing Address - Street 1:PO BOX 152168
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33684-2168
Mailing Address - Country:US
Mailing Address - Phone:813-443-4724
Mailing Address - Fax:813-443-4726
Practice Address - Street 1:7825 N DALE MABRY HWY
Practice Address - Street 2:STE 206 BLDG 6
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3286
Practice Address - Country:US
Practice Address - Phone:813-443-4724
Practice Address - Fax:813-443-4726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4313111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty