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General NPI Number Information
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NPI Number | 1659968998
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Entity Type | Organization
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Legal Business Name | FLORIDA MED GROUP LLC
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Dates
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Enumeration Date | 12/21/2020
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 4820 5TH AVENUE NORTH
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City | ST PETERSBURGH
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State | FL
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Zip | 33713-3371
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Country | US
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Telephone | 727-466-3000
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Fax | 727-844-5425
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Provider Business Mailing Address
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Address Line | PO BOX 7707
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City | CLEARWATER
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State | FL
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Zip | 33758-7707
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Country | US
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Telephone | 727-844-5404
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MUHAMMAD S HAYAT
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Credential | MD
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Telephone | 727-466-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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