| St Marys Family Practice Center | |
|
1152 62nd Ave S St Petersburg FL 33705-5620 | |
| (727) 866-6306 | |
| (727) 864-9614 |
| Full Name | St Marys Family Practice Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1152 62nd Ave S, St Petersburg, Florida |
| Authorized Official Name and Position | Sherif Mina Serag (OWNER) |
| Authorized Official Contact | 7278666306 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Marys Family Practice Center 1152 62nd Ave S St Petersburg FL 33705-5620 Ph: (727) 866-6306 | St Marys Family Practice Center 1152 62nd Ave S St Petersburg FL 33705-5620 Ph: (727) 866-6306 |
| NPI Number | 1487866687 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 10/01/2019 |
| Medicare PECOS PAC ID | 2668528282 |
|---|---|
| Medicare Enrollment ID | O20090923000791 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487866687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sherif Mina Serag |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881657658 PECOS PAC ID: 7719953520 Enrollment ID: I20040902001219 |
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