Healthcare Provider Details

I. General information

NPI: 1073033940
Provider Name (Legal Business Name): PATIENT PHYSICIAN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 US HIGHWAY 19 N STE 132
CLEARWATER FL
33764-7220
US

IV. Provider business mailing address

14100 US HIGHWAY 19 N STE 132
CLEARWATER FL
33764-7220
US

V. Phone/Fax

Practice location:
  • Phone: 727-954-7642
  • Fax: 727-898-9596
Mailing address:
  • Phone: 727-954-7642
  • Fax: 727-898-9596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: BARBARA JEANNE HOPKINS-HOCKMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 727-954-7642