SUNCOAST MEDICAL CLINIC LLC (NPI# 1265671812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265671812 |
| Entity Type | Organization |
| Organization Name | SUNCOAST MEDICAL CLINIC LLC |
| Practice Address |
601 7th St S St Petersburg FL 33701-4704 |
| Practice Telephone | 7278248357 |
| Practice Fax Number | 7278243132 |
| Mailing Telephone | 7278248357 |
| Mailing Fax Number | 7278243132 |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2009-02-05 |
| Authorized Official Name | GEROGE L ETTEL (PRESIDENT) |
| Authorized Official Telephone | 7278941818 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | SUNCOAST MEDICAL CLINIC LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QL0400X |
Clinic/Center Specialization: Lithotripsy |
790 | FL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205061140 | Suncoast Medical Clinic LLC | Clinic/Center | 601 7th St S, St Petersburg, FL 33701-4704 | 2009-05-21 |
| 1760664882 | Suncoast Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 1099 5th Ave N, Ste 130, St Petersburg, FL 33705-1469 | 2007-11-30 |
| 1306028428 | Suncoast Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 601 7th St S, St Petersburg, FL 33701-4704 | 2007-11-30 |
| 1821115841 | Suncoast Medical Clinic LLC | Clinic/Center | 601 7th St S, St Petersburg, FL 33701-4704 | 2007-03-23 |
| 1649397662 | Suncoast Medical Clinic LLC | Clinical Medical Laboratory | 601 7th St S, St Petersburg, FL 33701-4704 | 2007-03-23 |
| 1497866537 | Suncoast Medical Clinic LLC | Clinic/Center | 601 7th St S, St Petersburg, FL 33701-4704 | 2006-08-31 |
| Street Address |
601 7TH ST S |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33701-4704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740275791 | Alexandria S. Kongsiri | Dermatology | 601 7th St S, St Petersburg, FL 33701-4704 | 2005-09-15 |
| 1306113493 | Vonda Jackson Colquitt | Pharmacist | 601 7th St S, St Petersburg, FL 33701-4704 | 2011-11-17 |
| 1811278591 | Aquilla Walker | Pharmacist | 601 7th St S, St Petersburg, FL 33701-4704 | 2011-09-08 |
| 1467740738 | Optical Shop Inc | Eyewear Supplier (Equipment, not the service) | 601 7th St S, St Petersburg, FL 33701-4704 | 2011-07-20 |
| 1346549292 | Sc Physicians LLC | Clinic/Center | 601 7th St S, St Petersburg, FL 33701-4704 | 2011-03-17 |
| 1780983700 | Sc Physicians LLC | Radiology | 601 7th St S, St Petersburg, FL 33701-4704 | 2011-03-16 |
| 1205061140 | Suncoast Medical Clinic LLC | Clinic/Center | 601 7th St S, St Petersburg, FL 33701-4704 | 2009-05-21 |
| 1144491846 | Nicole Bernadette See | Nurse Practitioner | 601 7th St S, St Petersburg, FL 33701-4704 | 2008-03-20 |
| 1306028428 | Suncoast Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 601 7th St S, St Petersburg, FL 33701-4704 | 2007-11-30 |
| 1508060088 | Maritza Tovar Day | Family Medicine | 601 7th St S, St Petersburg, FL 33701-4704 | 2007-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514603 | Tien Thuy Hoang | Pharmacist | 875 Dr M.l.k. Jr St N, St. Petersburg, FL 33701 | 2020-10-06 |
| 1851920953 | Michelle Tedrowe | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg Family Care Center, 700 6th Street South, St. Petersburg, FL 33701 | 2020-04-02 |
| 1164070264 | Melissa Joy Fitzpatrick | Occupational Therapist | 239 14 Ave Ne, St Petersburg, FL 33701 | 2019-09-01 |
| 1841763091 | William Carpenter Scott | Dentist | 239 2nd Ave S # 100, St Petersburg, FL 33701 | 2019-01-09 |
| 1992289318 | Westminster Senior Services, Inc. | Registered Nurse | 830 North Shore Dr. Ne, St. Petersburg, FL 33701 | 2018-09-21 |
| 1265929780 | B&b Florida Eye Care Pllc | Optometrist | 1380 4th St N, St. Petersburg, FL 33701 | 2018-04-19 |
| 1730684895 | Loraine Marie Torres Garcia | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg, 700 6th Street South, St Petersburg, FL 33701 | 2018-03-29 |
| 1598267445 | Vincent Malik Dehili | Psychologist | 146 2nd Street North, Suite 305, St. Petersburg, FL 33701 | 2018-03-07 |
| 1770083073 | Megan Sanborn | Nurse Practitioner | 601 5th St S Ste 304, St Petersburg, FL 33701 | 2018-02-14 |
| 1174037089 | Julius Griffin | Licensed Practical Nurse | 1115 Highland St N, Apt B, Saint Petersburg, FL 33701 | 2017-11-30 |
| Find all providers in zip 33701 | ||||
| Taxonomy Code | 261QL0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Lithotripsy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619412699 | Ums Lithotripsy Services of Sarasota, LLC | Clinic/Center | 1 S School Ave Ste 103, Sarasota, FL 34237-6047 | 2016-12-29 |
| 1619258464 | Precision Lithotripsy LLC | Clinic/Center | 3490 N Us Highway 1, Cocoa, FL 32926-8724 | 2011-09-07 |
| City | ST PETERSBURG |
| Zip Code | 33701 |
Please comment or provide details below to improve the information on SUNCOAST MEDICAL CLINIC 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.