| Gulf Coast Internist, Llc. | |
|
4957 38th Ave N Suite C Saint Petersburg FL 33710-2174 | |
| (727) 525-0900 | |
| (727) 525-9500 |
| Full Name | Gulf Coast Internist, Llc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 4957 38th Ave N, Saint Petersburg, Florida |
| Authorized Official Name and Position | Kavita B Rao (MGRM) |
| Authorized Official Contact | 7277485699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Internist, Llc. 4957 38th Ave N Suite C Saint Petersburg FL 33710-2174 Ph: (727) 525-0900 | Gulf Coast Internist, Llc. 4957 38th Ave N Suite C Saint Petersburg FL 33710-2174 Ph: (727) 525-0900 |
| NPI Number | 1114155355 |
|---|---|
| Provider Enumeration Date | 06/25/2009 |
| Last Update Date | 09/19/2012 |
| Medicare PECOS PAC ID | 9032259239 |
|---|---|
| Medicare Enrollment ID | O20091219000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114155355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kavita B Rao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083684153 PECOS PAC ID: 5890778211 Enrollment ID: I20070418000231 |
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