Active NPI
Bay Area Mobile Clinic LLC
- Clinic/Center
- Dade City, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- BAY AREA MOBILE CLINIC LLC
- Practice address
- 15000 Citrus Country Dr # 414
Dade City, FL 33523-6014 - Phone
- (813) 924-8911
- NPI assigned
- Jan 24, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Junise Belizaire
- Title
- Owner
- Phone
- (813) 924-8911
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
15000 Citrus Country Dr # 414
Dade City, FL 33523-6014
Mailing address
15000 Citrus Country Dr # 414
Dade City, FL 33523-6014
Other practice location 1
7715 Bulls Head Dr
Wesley Chapel, FL 33545-7049
Phone (813) 924-8911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180511000891 | FL | Part B Supplier - Clinic/Group Practice | 0840554234 |
Receives reassigned benefits from 1 practitioner Practice locations: Dade City, FL |
National Provider Directory
National Provider DirectoryLocations
15000 Citrus Country Dr
#414
Dade City, FL 33523
Phone (813) 924-8911
5450 Bruce B Downs Blvd
Wesley Chapel, FL 33544
Phone (352) 232-3820
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516752000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1617062400000",
"number": "1235637398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15000 CITRUS COUNTRY DR # 414",
"city": "DADE CITY",
"state": "FL",
"postal_code": "335236014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15000 CITRUS COUNTRY DR # 414",
"city": "DADE CITY",
"state": "FL",
"postal_code": "335236014",
"telephone_number": "813-924-8911"
}
],
"practiceLocations": [
{
"address_1": "7715 Bulls Head Dr",
"address_purpose": "LOCATION",
"city": "Wesley Chapel",
"state": "FL",
"postal_code": "335457049",
"country_code": "US",
"telephone_number": "813-924-8911",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "BAY AREA MOBILE CLINIC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-24",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A",
"authorized_official_last_name": "BELIZAIRE",
"authorized_official_first_name": "JUNISE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "813-924-8911"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dade City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.