BAYSIDE MEDICAL PRACTICE OF VILANO BEACH LLC
NPI 1760168330
Clinic/Center - Primary Care in St Augustine, FL

Active since June 27, 2023CLIA 10D2293750 · Waiver
101 YACHT CLUB DR, ST AUGUSTINE, FL 32084(904) 217-4550(904) 907-2113 Get Directions Write a Review

NPPES record last updated: September 1, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 1, 2025, Feb 5, 2024 (2 updates tracked since 2024).

About Bayside Medical Practice Of Vilano Beach Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BAYSIDE MEDICAL PRACTICE OF VILANO BEACH LLC (NPI 1760168330) is a healthcare organization registered as a primary care in St Augustine, Florida and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through November 13, 2027, maintains a secondary practice location in St Augustine, and lists Tammy Rowland Dye, President, as its authorized official.

NPPES Registry Identity

NPI1760168330
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameBAYSIDE MEDICAL PRACTICE OF VILANO BEACH LLC
Location Address101 YACHT CLUB DRSt Augustine, FL 32084-2196
Mailing Address240 San Marco AveSaint Augustine, FL 32084-2729 · (904) 217-4550 · Fax (904) 907-2113
Fax(904) 907-2113
Organization SubpartNo
Authorized OfficialTammy Rowland DyePresident · (305) 916-0183
Enumeration DateJune 27, 2023
Last NPPES UpdateSeptember 1, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 1, 2025
NPI 1760168330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
101 YACHT CLUB DR, St Augustine, FL 32084

Secondary Practice Location 1

Location 1240 San Marco AveSt Augustine, FL 32084-2729 · Phone (904) 217-4550 · Fax (904) 907-2113

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2293750

Bayside Medical Practice Of Vilano Beach LLC · Saint Augustine, FL
Active · expires Nov 13, 2027
CLIA Number10D2293750
Laboratory TypePhysician Office
Certificate Effective DateNovember 14, 2025
Certificate Expiration DateNovember 13, 2027
Laboratory DirectorTammy R. Dye
Laboratory Phone(904) 217-4550
Laboratory LocationBayside Medical Practice Of Vilano Beach LLC101 Yacht Club Drive, Saint Augustine, FL 32084
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
101 YACHT CLUB DR
ST AUGUSTINE, FL 32084

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bayside Medical Practice Of Vilano Beach LLC's NPI number?

The NPI number for Bayside Medical Practice Of Vilano Beach LLC is 1760168330. It was assigned to this organization in the NPPES registry on June 27, 2023.

Where is Bayside Medical Practice Of Vilano Beach LLC located?

Bayside Medical Practice Of Vilano Beach LLC is located at 101 Yacht Club Dr, St Augustine, FL 32084. The listed phone number is (904) 217-4550.

What is Bayside Medical Practice Of Vilano Beach LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Bayside Medical Practice Of Vilano Beach LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2293750) is associated with this NPI, valid through November 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bayside Medical Practice Of Vilano Beach LLC was last updated on September 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.