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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

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Active Organization

2278H0200X · SAINT PETERSBURG, FL

Registration Details

NPI Number
1053902718
Provider Type
Organization
NPI Issued
Jan 26, 2021 (5.2753977575686 yrs)
Last Updated
Jan 26, 2021

Practice Information

Address
9720 EXECUTIVE CENTER DR N STE 100
SAINT PETERSBURG, FL, 337022440
Browse FL providers · Browse ZIP 33702
Phone
8176025079
Primary Specialty
2278H0200X
2278H0200X
Additional Specialty
2278H0200X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.