MEDICARE: VERIMED HEALTH GROUP PASADENA, LLC

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	207R00000X	Internal Medicine Physician	ME24494	FL

General Provider Information

NPI Number	:	1508021296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERIMED HEALTH GROUP PASADENA, LLC

Provider Business Mailing Address
First Line	:	7035 1ST AVE S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33707-1203
Country	:	US
Telephone Number	:	727-345-6337
Fax Number	:	727-347-0403

Provider Business Practice Location Address
First Line	:	7035 1ST AVE S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33707-1203
Country	:	US
Telephone Number	:	727-345-6337
Fax Number	:	727-347-0403

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. RENNEE CALOGERO
Credential	:
Telephone Number	:	727-345-6337

Provider Enumeration Date	:	07/23/2008
Last Update Date	:	05/10/2018

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