Organization
BAYCARE MEDICAL GROUP INC
Active
Other names
Jackson Street Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA GORKEN (VP)
(727) 281-9202
Entity
Organization
Contact information
Practice address
560 JACKSON ST N STE 302, ST PETERSBURG, FL 33705-1449
(727) 895-9640
(727) 895-9692
Mailing address
2995 DREW ST FL 3, CLEARWATER, FL 33759-3012
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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