BAY AREA DIRECT CLIENT CARE LLC NPI 1356835862

NPI Information

NPI: 1356835862
Provider Name: BAY AREA DIRECT CLIENT CARE LLC
Classification: Internal Medicine - 207RI0001X
Entity Type: Organization

Specialization: Clinical & Laboratory Immunology

CLIA Number: 10D2229252

Address:
110 LITHIA PINECREST RD STE B
BRANDON, FL
ZIP 33511
Phone: (813) 679-5122
Get Directions

BAY AREA DIRECT CLIENT CARE LLC is a clinical and laboratory immunology internal medicine in Brandon, FL. The provider is an internal medicine physician who specializes in clinical and laboratory immunology disease management. BAY AREA DIRECT CLIENT CARE LLC NPI is 1356835862. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

110 LITHIA PINECREST RD STE B
BRANDON, FL
ZIP 33511-300
Phone: (813) 679-5122

The provider's authorized official is Deshae Martin .
The authorized official title is Administrative Director and has the following contact phone number (813) 585-7708.

The CLIA number assigned to this NPI record is 10D2229252 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/18/2018 and was last updated on 6/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	207RI0001X	Internal Medicine	Clinical & Laboratory Immunology		Yes
2	251E00000X	Home Health			No
3	251J00000X	Nursing Care			No
4	313M00000X	Nursing Facility/Intermediate Care Facility			No
5	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities			No
6	373H00000X	Day Training/Habilitation Specialist		FLORIDA	No
7	385HR2060X	Respite Care	Respite Care, Intellectual and/or Developmental Disabilities		No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NONE	OTHER	FLORIDA	NONE ASSOCIATED
2	025147900	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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