Organization
BAYCARE MEDICAL GROUP PEDIATRIC WALK-IN, LLC
Active
Parent organization
BAYCARE MEDICAL GROUP, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYCARE MEDICAL GROUP, INC
Authorized official
MR. TOMMY INZENA (PRESIDENT/CEO)
(813) 636-2044
Entity
Organization
Contact information
Practice address
4902 EISENHOWER BLVD, SUITE 300, TAMPA, FL 33634-6310
(813) 636-2044
(813) 321-6998
Mailing address
PO BOX 743409, ATLANTA, GA 30374-3409
(727) 532-0002
(727) 532-1325
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/10/2008
Last updated
01/06/2017
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