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NPI Code Detail

MEDICARE: FIFTH AVENUE PEDIATRICS, PA

MEDICARE: FIFTH AVENUE PEDIATRICS, PA
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
1208000000XPediatrics Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255312666
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIFTH AVENUE PEDIATRICS, PA
Provider Business Mailing Address
First Line : 2855 5TH AVE N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33713-6701
Country : US
Telephone Number : 727-323-2727
Fax Number : 727-327-8101
Provider Business Practice Location Address
First Line : 2855 5TH AVE N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33713-6701
Country : US
Telephone Number : 727-323-2727
Fax Number : 727-327-8101
Authorized Official
Title or Position : PRESIDENT
Name : PAMELA M PATRANELLA
Credential : MD
Telephone Number : 727-323-2727
Provider Enumeration Date : 11/11/2005
Last Update Date : 03/22/2013

Similar Medicare Providers

1639812522 — HEATHER M DEREUS MD
Practice Location Address:
2855 5TH AVE N
ST PETERSBURG, FL
33713-6701
Practice Phone: 727-323-2727
Practice Fax: 727-327-8101
1851373153 — SALLY M SMITH
Practice Location Address:
2855 5TH AVE N
ST PETERSBURG, FL
33713-6701
Practice Phone: 727-323-2727
Practice Fax: 727-327-8101
1023090461 — JULIE D JOHNSON MD
Practice Location Address:
2855 5TH AVE N
ST PETERSBURG, FL
33713-6701
Practice Phone: 727-323-2727
Practice Fax: 727-327-8101
1568444909 — PAMELA M PATRANELLA MD
Practice Location Address:
2855 5TH AVE N
ST PETERSBURG, FL
33713-6701
Practice Phone: 727-323-2727
Practice Fax: 727-327-8101
1992787337 — ANN R WINKLER MD
Practice Location Address:
2855 5TH AVE N
ST PETERSBURG, FL
33713-6701
Practice Phone: 727-323-2727
Practice Fax: 727-327-8101
1891844007 — JOYCE ELIZABETH SLYDER APRN, FNP
Practice Location Address:
2855 5TH AVE N
SAINT PETERSBURG, FL
33713-6701
Practice Phone: 727-323-2727
Practice Fax: 727-327-8101

Directions to “FIFTH AVENUE PEDIATRICS, PA ” Practice Location

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