Provider Demographics
NPI:1114816402
Name:BAY HARBOR PEDIATRICS
Entity type:Organization
Organization Name:BAY HARBOR PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:GRABOIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-725-9475
Mailing Address - Street 1:1111 KANE CONCOURSE STE 504
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2043
Mailing Address - Country:US
Mailing Address - Phone:786-558-4560
Mailing Address - Fax:786-558-4560
Practice Address - Street 1:1111 KANE CONCOURSE STE 504
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2043
Practice Address - Country:US
Practice Address - Phone:786-558-4560
Practice Address - Fax:786-558-4560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty