Healthcare Provider Details

I. General information

NPI: 1548411432
Provider Name (Legal Business Name): MYRTLE AVENUE PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 SO. MYRTLE AVE.
CLEARWATER FL
33756
US

IV. Provider business mailing address

613 SO. MYRTLE AVENUE
CLEARWATER FL
33756
US

V. Phone/Fax

Practice location:
  • Phone: 727-447-6458
  • Fax: 727-461-5211
Mailing address:
  • Phone: 727-447-6458
  • Fax: 727-461-5211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GREG HOWARD SAVEL
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 727-447-6458