MEDICARE: PROVIDENCE MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	326	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	R9114	OTHER	FL	BCBS OF FLORIDA

General Provider Information

NPI Number	:	1225027493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROVIDENCE MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 48833
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33743-8833
Country	:	US
Telephone Number	:	727-540-9377
Fax Number	:	727-540-9387

Provider Business Practice Location Address
First Line	:	3350 ULMERTON RD
Second Line	:	SUITE 16
City	:	CLEARWATER
State	:	FL
Zip	:	33762-3397
Country	:	US
Telephone Number	:	727-540-9377
Fax Number	:	727-540-9387

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DAVID RICHARD LEVERING JR.
Credential	:
Telephone Number	:	727-540-9377

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	08/26/2014

Similar Medicare Providers

1083910061 — MRS. JOSEE SCULLY
Practice Location Address:

430 MORTON PLANT ST STE 101
CLEARWATER, FL
33756-3397

Practice Phone: 727-462-7237
Practice Fax:

1235641663 — MARIA SKOPIS DO
Practice Location Address:

430 MORTON PLANT ST STE 100
CLEARWATER, FL
33756-3397

Practice Phone: 727-461-8970
Practice Fax:

1093223893 — AUSTIN MICHAEL CALANTONI DPT
Practice Location Address:

430 MORTON PLANT ST STE 101
CLEARWATER, FL
33756-3397

Practice Phone: 727-461-8331
Practice Fax:

1396740890 — MR. WOUTER VANDERHORST P.T.
Practice Location Address:

14141 46TH N ST 1202
CLEARWATER, FL
33762-3860

Practice Phone: 727-535-6746
Practice Fax: 727-536-6006

1295730794 — HEALING THE GENERATIONS, INC.
Practice Location Address:

14141 46TH ST N , SUITE 1202
CLEARWATER, FL
33762-3867

Practice Phone: 727-535-6746
Practice Fax: 727-536-6006

1174522916 — MS. MODUPE D MCINTOSH CPNP
Practice Location Address:

13577 FEATHER SOUND DR
CLEARWATER, FL
33762-2258

Practice Phone: 904-902-4408
Practice Fax: 904-420-4745

Directions to “PROVIDENCE MEDICAL CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.