| Bayside Medical | |
|
301 N Brevard Ave Suite B Arcadia FL 34266-4501 | |
| (863) 494-2293 | |
| (863) 494-1520 |
| Full Name | Bayside Medical |
|---|---|
| Speciality | Internal Medicine |
| Location | 301 N Brevard Ave, Arcadia, Florida |
| Authorized Official Name and Position | Charles R. Habelow (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8634942293 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayside Medical Po Box 510310 Punta Gorda FL 33951-0310 Ph: (863) 494-2293 | Bayside Medical 301 N Brevard Ave Suite B Arcadia FL 34266-4501 Ph: (863) 494-2293 |
| NPI Number | 1508029349 |
|---|---|
| Provider Enumeration Date | 07/02/2008 |
| Last Update Date | 10/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508029349 | NPI | - | NPPES |
| DN9810 | Other | FL | RAILROAD MEDICARE B PTAN |
| 046638701 | Medicaid | FL | |
| 1881601946 | Other | FL | NPI, TYPE I |
| 1508029349 | Other | FL | NPI , TYPE II |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME49217 (Florida) | Primary |
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