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NPI Code Detail

MEDICARE: COMMUNITY HEALTH CENTER OF PINELLAS INC

MEDICARE: COMMUNITY HEALTH CENTER OF PINELLAS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician
3207V00000XObstetrics & Gynecology Physician
4208000000XPediatrics Physician
5208D00000XGeneral Practice Physician
6261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346228061
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTH CENTER OF PINELLAS INC
Provider Business Mailing Address
First Line : PO BOX 10549
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33733-0549
Country : US
Telephone Number : 727-824-8126
Fax Number : 727-824-8166
Provider Business Practice Location Address
First Line : 247 S HUEY AVE
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-4205
Country : US
Telephone Number : 727-944-3828
Fax Number : 727-939-4679
Authorized Official
Title or Position : CHIEF REGULATORY OFFICER
Name : EDWARD KUCHER
Credential :
Telephone Number : 727-824-8100
Provider Enumeration Date : 01/03/2006
Last Update Date : 06/06/2025

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1740538560 — MS. SUSAN ELIZABETH CASE
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Directions to “COMMUNITY HEALTH CENTER OF PINELLAS INC ” Practice Location

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