Organization
BAY AREA IPA, LLC
Active
Other names
Citrus Park Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
SHITAL MEHTA D.O. (OWNER)
(813) 964-8526
Entity
Organization
Contact information
Practice address
8911 SILVERTHORN RD, LARGO, FL 33777-3170
(727) 270-0034
Mailing address
8911 SILVERTHORN RD, LARGO, FL 33777-3170
(727) 270-0034
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271714000
—
FL
Enumeration date
10/12/2020
Last updated
10/12/2020
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