Organization Active NPI

Bayside Surgical Associates

  • Surgery Physician
  • Panama City, FL
National Provider Identifier
1841305398
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BAYSIDE SURGICAL ASSOCIATES
Practice address
2933 Martin Luther King Jr Blvd
Panama City, FL 32405-4411
Phone
(850) 913-6958
Fax
(850) 913-6959
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Shireen S Rahman
Title
Office Manager
Phone
(850) 276-1328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2933 Martin Luther King Jr Blvd
Panama City, FL 32405-4411

Mailing address

2933 Martin Luther King Jr Blvd
Panama City, FL 32405-4411
Phone (850) 913-6958

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841305398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 MARTIN LUTHER KING JR BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054411",
            "telephone_number": "850-913-6958",
            "fax_number": "850-913-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 MARTIN LUTHER KING JR BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054411",
            "telephone_number": "850-913-6958",
            "fax_number": "850-913-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "SHIREEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-276-1328"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • 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.