PINELLAS VASCULAR LLC (NPI# 1174173421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174173421 |
| Entity Type | Organization |
| Organization Name | PINELLAS VASCULAR LLC |
| Practice Address |
5880 49th St N Ste 206 St Petersburg FL 33709-2147 |
| Mailing Address |
5260 78th Ave N # 2776 Pinellas Park FL 33781-2347 |
| Practice Telephone | 8139972099 |
| Mailing Telephone | 8133882935 |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-10-28 |
| Authorized Official Name | JEFF MATHEW (PRESIDENT) |
| Authorized Official Telephone | 8139972099 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
5880 49TH ST N STE 206 |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33709-2147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780746008 | Jeff Mathew | Surgery | 5880 49th St N Ste 206, St Petersburg, FL 33709-2147 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770110637 | Mylien Le | Registered Nurse | 6001 49th Street North, St Petersburg, FL 33709 | 2020-03-23 |
| 1457885063 | Kamlesh Rajani | Pharmacist | 5985-b 49th Street North, Saint Petersburg, FL 33709 | 2017-04-20 |
| 1417382912 | Farhan Hooda | Internal Medicine | The Heart Institute, 6006 49th St. North, Ste. 200, St. Petersburg, FL 33709 | 2013-09-04 |
| 1558702605 | Walgreens | Clinic/Center | 3994 Tyrone Blvd, Saint Petersburg, FL 33709 | 2013-07-17 |
| 1437417607 | Jeri Devale | Social Worker | 6241 43rd Ter N, Kenneth City, FL 33709 | 2012-04-25 |
| 1528340643 | Steven E. Allbritton | Pharmacist | 5405 66th Street N., Saint Petersburg, FL 33709 | 2011-09-14 |
| 1043537335 | Milan Ravindra Patel | Internal Medicine | 3901 66th St N Ste 201, St Petersburg, FL 33709 | 2010-04-26 |
| 1134454713 | Eye Designs Optical and Vision Care, LLC | Optometrist | 3831 Tyrone Boulevard, St. Petersburg, FL 33709 | 2009-10-15 |
| 1487827069 | Jose Manuel Garcia | Dentist | 4911 Park Street North, St Petersburg, FL 33709 | 2008-04-04 |
| 1104097427 | Stanley D Grimmel | Chiropractor | 5670 54th Ave. N, A2, Saint Petersburg, FL 33709 | 2008-03-13 |
| Find all providers in zip 33709 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780746008 | Jeff Mathew | Surgery | 5880 49th St N Ste 206, St Petersburg, FL 33709-2147 | 2006-12-14 |
| 1033205356 | George R Daicoff | Surgery | 4950 28th Ave N, St Petersburg, FL 33710-2742 | 2006-10-05 |
| 1619080793 | William Maurice Blackshear Jr. | Surgery | 7292 4th St N, Suite B, St Petersburg, FL 33702-5813 | 2006-08-16 |
| 1427390608 | Vascular Interventional Pavilion, LLC | Surgery | 3500 38th Ave N, St Petersburg, FL 33713-1448 | 2013-03-26 |
| 1568731958 | William M Blackshear Jr Md Pa | Surgery | 7292 4th St N, Suite B, St Petersburg, FL 33702-5813 | 2011-12-14 |
| 1083904593 | Chun Kevin Yang | Surgery | 960 7th Ave N, St Petersburg, FL 33705-1347 | 2011-04-18 |
| 1871810655 | Benjamin Edward Szpila | Surgery | 960 7th Ave N, St Petersburg, FL 33705-1347 | 2010-05-03 |
| 1346219698 | Ralph Angelo Dematteis | Surgery | 2191 9th Ave N, Suite 110, St Petersburg, FL 33713-7146 | 2006-03-17 |
| 1962499715 | Paul Steven Collins | Surgery | 960 7th Ave N, St Petersburg, FL 33705-1347 | 2005-10-05 |
| 1013903244 | Eugene A Murphy | Surgery | 620 10th Street N., St Petersburg, FL 33705-1407 | 2005-09-22 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33709 |
Please comment or provide details below to improve the information on PINELLAS VASCULAR LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.