Bayside Healthcare Brandon, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

HCC6754 Issued in FL

Legal business name

BAYSIDE HEALTHCARE BRANDON, INC

Practice address

615 Vonderburg Dr
Brandon, FL 33511-5972

Phone

(813) 654-1856

Fax

(813) 681-7268

NPI assigned

Aug 6, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Donofrio

Title

President

Phone

(813) 654-1856

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Suncoast Total Healthcare Doing business as

Locations

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1356532246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118818",
            "telephone_number": "813-654-1856",
            "fax_number": "813-681-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115972",
            "telephone_number": "813-654-1856",
            "fax_number": "813-681-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE HEALTHCARE BRANDON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "DONOFRIO",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-654-1856",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "HCC6754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "HCC6754",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suncoast Total Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bay Area Speech-Language and Cognitive Therapy LLC
• Bay Area Surgicenter, LLC
• Bay Dermatology Associates Jerry L Hedrick MD PA
• Bayada Home Health Care, Inc.
• Bayside Healthcare Brandon Inc
• BDL National Inc
• Bea Hilbrands LMHC, LLC
• Rebecca Beach, RBT
• Sherri Beach, M.S.
• Patrick J Beahon, M.ED.

• Family Medicine Physician in Brandon, FL
• Providers in Brandon, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.