| |
1501 S Missouri Ave, Clearwater, FL 33756-2236 | |
(727) 488-8044 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Family Medicine - Sports Medicine |
Location | 1501 S Missouri Ave, Clearwater, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043551344 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111NN0400X | Chiropractor - Neurology | CH10323 (Florida) | Secondary |
207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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1501 S Missouri Ave, Clearwater, FL 33756-2236 Ph: (727) 488-8044 | 1501 S Missouri Ave, Clearwater, FL 33756-2236 Ph: (727) 488-8044 |