| Love The Golden Rule Inc | |
|
3600 Central Ave St Petersburg FL 33711-1345 | |
| (727) 826-0700 | |
| (727) 954-6994 |
| Full Name | Love The Golden Rule Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3600 Central Ave, St Petersburg, Florida |
| Authorized Official Name and Position | Robert Jennings Wallace (CEO/MEDICAL DIRECTOR) |
| Authorized Official Contact | 7278260700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Love The Golden Rule Inc 3600 Central Ave St Petersburg FL 33711-1345 Ph: (727) 826-0700 | Love The Golden Rule Inc 3600 Central Ave St Petersburg FL 33711-1345 Ph: (727) 826-0700 |
| NPI Number | 1831580612 |
|---|---|
| Provider Enumeration Date | 02/14/2015 |
| Last Update Date | 12/28/2023 |
| Medicare PECOS PAC ID | 3971820481 |
|---|---|
| Medicare Enrollment ID | O20150323000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831580612 | NPI | - | NPPES |
| 62574W | Medicaid | FL | |
| 1821396151 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME42522 (Florida) | Primary |
| Provider Name | Robert J Wallace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821396151 PECOS PAC ID: 6608027651 Enrollment ID: I20121121000454 |
| Provider Name | Craig F Callam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538799747 PECOS PAC ID: 2365872561 Enrollment ID: I20200430000005 |
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