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General NPI Number Information
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NPI Number | 1285765040
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Entity Type | Organization
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Legal Business Name | PINELLAS MEDICAL ASSOCIATES, PA
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 5880 49TH ST N STE 104
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City | ST PETERSBURG
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State | FL
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Zip | 33709-2142
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Country | US
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Telephone | 727-528-6100
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Fax | 727-528-7895
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Provider Business Mailing Address
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Address Line | 5880 49TH ST N STE N104
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City | ST PETERSBURG
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State | FL
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Zip | 33709-2150
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Country | US
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Telephone | 727-528-6100
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Fax | 727-528-7895
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Authorized Official
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Title or Position | OWNER
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Name | DR. LISA A FLAHERTY
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Credential | D.O.
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Telephone | 727-528-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA910479
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | OS9206
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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