Healthcare Provider Details

I. General information

NPI: 1194812552
Provider Name (Legal Business Name): NORTH PINELLAS CHILDRENS MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31860 US HIGHWAY 19 N
PALM HARBOR FL
34684-3713
US

IV. Provider business mailing address

31860 US HIGHWAY 19 N
PALM HARBOR FL
34684-3713
US

V. Phone/Fax

Practice location:
  • Phone: 727-787-6335
  • Fax: 727-772-2160
Mailing address:
  • Phone: 727-787-6335
  • Fax: 727-772-2160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EFSTRATIOS PANTAGES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 727-787-6335