Healthcare Provider Details
I. General information
NPI: 1205954666
Provider Name (Legal Business Name): PAUTLER COHEN FINDLAY EICHENBAUM WHITE AND CRANE MDS PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2007
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4344 CENTRAL AVE
ST PETERSBURG FL
33711-1141
US
IV. Provider business mailing address
4344 CENTRAL AVE
ST PETERSBURG FL
33711-1141
US
V. Phone/Fax
- Phone: 727-323-0077
- Fax: 727-323-7627
- Phone: 727-323-0077
- Fax: 727-323-7627
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207WX0107X |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAMELA
JANE
PAUTLER
Title or Position: ADMINISTRATOR
Credential: ESQ
Phone: 813-879-5795