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NPI Code Detail

MEDICARE: SUNCOAST FAMILY MEDICAL ASSOCIATES

MEDICARE: SUNCOAST FAMILY MEDICAL ASSOCIATES
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
1111N00000XChiropractorCH5247FL
2207Q00000XFamily Medicine PhysicianOS6098FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
121242AOTHERFLBLUE CROSS
2120374OTHERHUMANA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811981178
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNCOAST FAMILY MEDICAL ASSOCIATES
Provider Business Mailing Address
First Line : 12020 SEMINOLE BLVD
Second Line :
City : LARGO
State : FL
Zip : 33778-2805
Country : US
Telephone Number : 727-588-9572
Fax Number : 727-584-3832
Provider Business Practice Location Address
First Line : 12020 SEMINOLE BLVD
Second Line :
City : LARGO
State : FL
Zip : 33778-2805
Country : US
Telephone Number : 727-588-9572
Fax Number : 727-584-3832
Authorized Official
Title or Position : PRESIDENT
Name : JEFFREY S GROVE
Credential : D.O.
Telephone Number : 727-588-9572
Provider Enumeration Date : 09/01/2005
Last Update Date : 01/24/2013

Similar Medicare Providers

1285626382 — TY L TVEDTEN D.O.
Practice Location Address:
12020 SEMINOLE BLVD
LARGO, FL
33778-2805
Practice Phone: 727-588-9572
Practice Fax: 727-584-3832
1154313252 — JEFFREY SCOTT GROVE D.O.
Practice Location Address:
12020 SEMINOLE BLVD
LARGO, FL
33778-2805
Practice Phone: 727-588-9572
Practice Fax: 727-584-3832
1033183207 — DR. RICK LEE DASO DC
Practice Location Address:
12020 SEMINOLE BLVD
LARGO, FL
33778-2805
Practice Phone: 727-595-2273
Practice Fax: 727-584-3832
1891729513 — KRISTA MICHELLE KEITH DO
Practice Location Address:
12020 SEMINOLE BLVD , SUNCOAST FAMILY MEDICAL ASSOCIATES
LARGO, FL
33778-2805
Practice Phone: 727-588-9572
Practice Fax: 727-584-3832
1033422779 — DR. ENRIQUE JOSE URRUTIA JR. D.O.
Practice Location Address:
12020 SEMINOLE BLVD
LARGO, FL
33778-2805
Practice Phone: 727-588-9572
Practice Fax: 727-584-3832
1467761064 — DR. EUGENE MICHAEL DIBETTA JR. D.O.
Practice Location Address:
12020 SEMINOLE BLVD
LARGO, FL
33778-2805
Practice Phone: 727-588-9572
Practice Fax: 727-584-3832

Directions to “SUNCOAST FAMILY MEDICAL ASSOCIATES ” Practice Location

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