1063092047 NPI number — TAMPA BAY JOINT AND SPINE, LLC

Table of content: DR. JAMES LYNCH BAILEY M.D. (NPI 1508897877)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063092047 NPI number — TAMPA BAY JOINT AND SPINE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TAMPA BAY JOINT AND SPINE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TAMPA BAY JOINT AND SPINE SURGERY CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063092047
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26034 US HIGHWAY 19 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEARWATER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33763-2043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-371-2500
Provider Business Mailing Address Fax Number:
727-371-2501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26034 US HIGHWAY 19 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEARWATER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33763-2043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-371-2500
Provider Business Practice Location Address Fax Number:
727-371-2501
Provider Enumeration Date:
04/13/2021

Additional Information

Authorized Official

Authorized Official Last Name:
LEMAISTRE
Authorized Official First Name:
COLLIN
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICER/AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
469-250-3640

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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