# BAYCARE MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Suncoast Medical Clinic Ophthalmology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093385452
- **Authorized official:** LYNDA GORKEN (VP, PFS)
- **Authorized official phone:** (727) 281-9202

## Contact information

- **Practice address:** 620 10TH ST N STE 2C, ST PETERSBURG, FL 33705-1407
- **Practice address phone:** (727) 824-7134
- **Practice address fax:** (727) 724-8329
- **Mailing address:** 2995 DREW ST FL 3, CLEARWATER, FL 33759-3012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2021
- **Last updated:** 06/29/2021