Provider Demographics
NPI:1760443527
Name:BAYSIDE PEDIATRICS, INC
Entity type:Organization
Organization Name:BAYSIDE PEDIATRICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JIMELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARGOTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-885-1770
Mailing Address - Street 1:6801 SHELDON RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-2754
Mailing Address - Country:US
Mailing Address - Phone:813-885-1770
Mailing Address - Fax:813-889-8078
Practice Address - Street 1:6801 SHELDON RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-2754
Practice Address - Country:US
Practice Address - Phone:813-885-1770
Practice Address - Fax:813-889-8078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty