| Tampa Bay Maxillofacial Surgery, Pllc | |
|
2140 16th St N St Petersburg FL 33704-3924 | |
| (727) 894-1442 | |
| Not Available |
| Full Name | Tampa Bay Maxillofacial Surgery, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 2140 16th St N, St Petersburg, Florida |
| Authorized Official Name and Position | Robert J Yu (MANAGING MEMBER) |
| Authorized Official Contact | 7278941442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tampa Bay Maxillofacial Surgery, Pllc 4021 Las Palmas Way Sarasota FL 34238-4531 Ph: (727) 424-5540 | Tampa Bay Maxillofacial Surgery, Pllc 2140 16th St N St Petersburg FL 33704-3924 Ph: (727) 894-1442 |
| NPI Number | 1164932356 |
|---|---|
| Provider Enumeration Date | 10/03/2017 |
| Last Update Date | 06/21/2019 |
| Medicare PECOS PAC ID | 2860750817 |
|---|---|
| Medicare Enrollment ID | O20171220001099 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164932356 | NPI | - | NPPES |
| Provider Name | Robert Chuong |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1558369678 PECOS PAC ID: 2567639974 Enrollment ID: I20120125000258 |
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