| Diagnostic Clinic Medical Group, Pa | |
|
1551 W Bay Dr Rehabilitation Department Largo FL 33770-2209 | |
| (727) 531-8767 | |
| Not Available |
| Full Name | Diagnostic Clinic Medical Group, Pa |
|---|---|
| Speciality | Physical Therapist |
| Location | 1551 W Bay Dr, Largo, Florida |
| Authorized Official Name and Position | Michael A.m. Bosman (CONSULTANT) |
| Authorized Official Contact | 7275818767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diagnostic Clinic Medical Group, Pa 1551 West Bay Drive Attn: Kelly Gregg Largo FL 33770-6805 Ph: (727) 531-8767 | Diagnostic Clinic Medical Group, Pa 1551 W Bay Dr Rehabilitation Department Largo FL 33770-2209 Ph: (727) 531-8767 |
| NPI Number | 1073517090 |
|---|---|
| Provider Enumeration Date | 06/08/2005 |
| Last Update Date | 11/25/2020 |
| Certification Date | 11/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073517090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | SW7076 (Florida) | Secondary |
| 225100000X | Physical Therapist | PT 15206 (Florida) | Primary |
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