| Diagnostic Clinic Medical Group, Inc. | |
|
6776 54th Ave N Suite B St Petersburg FL 33709-1405 | |
| (727) 548-8500 | |
| (727) 317-3758 |
| Full Name | Diagnostic Clinic Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 6776 54th Ave N, St Petersburg, Florida |
| Authorized Official Name and Position | Gina M Prebeck (VP OF OPERATIONS) |
| Authorized Official Contact | 7275818767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diagnostic Clinic Medical Group, Inc. 6776 54th Ave N Suite B St Petersburg FL 33709-1405 Ph: (727) 548-8500 | Diagnostic Clinic Medical Group, Inc. 6776 54th Ave N Suite B St Petersburg FL 33709-1405 Ph: (727) 548-8500 |
| NPI Number | 1609222405 |
|---|---|
| Provider Enumeration Date | 05/11/2016 |
| Last Update Date | 11/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609222405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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