Healthcare Provider Details

I. General information

NPI: 1285765040
Provider Name (Legal Business Name): PINELLAS MEDICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5880 49TH ST N STE 104
ST PETERSBURG FL
33709-2142
US

IV. Provider business mailing address

5880 49TH ST N STE N104
ST PETERSBURG FL
33709-2150
US

V. Phone/Fax

Practice location:
  • Phone: 727-528-6100
  • Fax: 727-528-7895
Mailing address:
  • Phone: 727-528-6100
  • Fax: 727-528-7895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA910479
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberOS9206
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LISA A FLAHERTY
Title or Position: OWNER
Credential: D.O.
Phone: 727-528-6100