| Southern Physicians Group Llc | |
|
1609 Pasadena Ave S Ste 1e South Pasadena FL 33707-4555 | |
| (919) 349-1232 | |
| (727) 677-9333 |
| Full Name | Southern Physicians Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1609 Pasadena Ave S Ste 1e, South Pasadena, Florida |
| Authorized Official Name and Position | Bryan Fink (PRESIDENT) |
| Authorized Official Contact | 7276779333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Physicians Group Llc 7045 75th St N Pinellas Park FL 33781-3748 Ph: (919) 349-1232 | Southern Physicians Group Llc 1609 Pasadena Ave S Ste 1e South Pasadena FL 33707-4555 Ph: (919) 349-1232 |
| NPI Number | 1245098185 |
|---|---|
| Provider Enumeration Date | 03/06/2024 |
| Last Update Date | 03/18/2024 |
| Medicare PECOS PAC ID | 9739527474 |
|---|---|
| Medicare Enrollment ID | O20240401002290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245098185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | (* (Not Available)) | Secondary |
| Provider Name | Bryan Patrick Fink |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568952869 PECOS PAC ID: 2668862616 Enrollment ID: I20211206001418 |
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