Bay Area Neuro Clinic Inc

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

BAY AREA NEURO CLINIC INC

Practice address

6275 E Fowler Ave
Temple Terrace, FL 33617

Phone

(813) 985-3773

Fax

(813) 984-7171

NPI assigned

Dec 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jose Vicente Bustamante, LICENSE MASSAGE THER

Title

President

Phone

(813) 985-3773

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194889709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6275 E FOWLER AVE",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "33617",
            "telephone_number": "813-985-3773",
            "fax_number": "813-984-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6275 E FOWLER AVE",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "33617",
            "telephone_number": "813-985-3773",
            "fax_number": "813-984-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA NEURO CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUSTAMANTE",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "VICENTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-985-3773",
        "authorized_official_credential": "LICENSE MASSAGE THER"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "C5112",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Basler
• Tania Efigenia Bastardo, APRN
• Camilo De Jesus Basulto Martinez
• Baws Express Medical Supplies Inc
• Jo Anne L Baxter, N.P
• Bay Area Restorative Therapy Services, LLC
• Baymotion Transit LLC
• Becky Baynham, OTR
• Mary Ellen Beatty, MD
• Rose Beauge

• All providers in Temple Terrace, FL
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.