Healthcare Provider Details

I. General information

NPI: 1427438043
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER OF PINELLAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13800 66TH ST BLDG Y RM 123
LARGO FL
33771-4909
US

IV. Provider business mailing address

14100 58TH ST N STE 100
CLEARWATER FL
33760-9900
US

V. Phone/Fax

Practice location:
  • Phone: 727-824-8181
  • Fax:
Mailing address:
  • Phone: 727-824-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: EDWARD KUCHER
Title or Position: CHIEF REGULATORY OFFICER
Credential:
Phone: 727-824-8100