Organization
BAY PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KING (ADMINISTRATIVE ASSISTANT)
(727) 767-4755
Entity
Organization
Contact information
Practice address
501 DR MARTIN LUTHER KING JR ST S, ST PETERSBURG, FL 33705-1814
(727) 822-7344
Mailing address
501 DR MARTIN LUTHER KING JR ST S, ST PETERSBURG, FL 33705-1814
(727) 822-7344
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
Other
Enumeration date
07/11/2006
Last updated
08/22/2020
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