Provider Demographics
NPI:1972584829
Name:BAY AREA CHEST PHYSICIANS P A
Entity type:Organization
Organization Name:BAY AREA CHEST PHYSICIANS P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-443-0611
Mailing Address - Street 1:430 MORTON PLANT STREET
Mailing Address - Street 2:SUITE 405
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3394
Mailing Address - Country:US
Mailing Address - Phone:727-443-0611
Mailing Address - Fax:727-461-5493
Practice Address - Street 1:430 MORTON PLANT STREET
Practice Address - Street 2:SUITE 405
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3394
Practice Address - Country:US
Practice Address - Phone:727-443-0611
Practice Address - Fax:727-461-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267138700Medicaid
FL267138700Medicaid
=========OtherEIN
FL267138700Medicaid