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Organization
ALLIGATOR BAY INPATIENT SERVICES LLC
Active
Organization
ALLIGATOR BAY INPATIENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY BYRNE MD (PRESIDENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
21298 OLEAN BLVD, PORT CHARLOTTE, FL 33952-6705
(469) 401-2386
(214) 712-2444
Mailing address
13737 NOEL RD, STE 1600, DALLAS, TX 75240-1331
(469) 401-2386
(214) 712-2444
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/17/2013
Last updated
10/22/2013
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