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General NPI Number Information
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NPI Number | 1427899798
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Entity Type | Organization
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Legal Business Name | PMG INPATIENT SERVICES LLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 5101 BRITTANY DR S
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City | ST PETERSBURG
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State | FL
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Zip | 33715-1565
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Country | US
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Telephone | 279-547-2047
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Fax |
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Provider Business Mailing Address
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Address Line | 200 2ND AVE S # 781
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4313
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Country | US
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Telephone | 727-954-7204
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Fax |
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Authorized Official
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Title or Position | SVP OF ADMINISTRATIVE SERVICES
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Name | NICOLE HOWARD
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Credential |
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Telephone | 337-991-9276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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