| NPI | 1407641756 |
|---|---|
| Doing Business As | BAYOUSIDE HEALTH & WELLNESS |
| Entity Type | Organization |
| Authorized Contact | LARA CORTES Practice Owner 727-935-1185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2025-04-09 |
| Last Update Date | 2025-04-09 |