MEDICARE: INFECTIOUS DISEASE CONSULTANTS OF ST. PETERSBURG, P.A.

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	207RI0200X	Infectious Disease Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CB6866	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5600211	OTHER		GHI
2	34252	OTHER	FL	BLUE CROSS/BLUE SHIELD FL
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982637195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFECTIOUS DISEASE CONSULTANTS OF ST. PETERSBURG, P.A.

Provider Business Mailing Address
First Line	:	4604 29TH ST E
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-9793
Country	:	US
Telephone Number	:	941-845-4572
Fax Number	:	941-845-4572

Provider Business Practice Location Address
First Line	:	4604 29TH ST E
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-9793
Country	:	US
Telephone Number	:	941-845-4572
Fax Number	:	941-845-4572

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CLINTON DOUGLAS HOLDER
Credential	:	M.D.
Telephone Number	:	941-845-4572

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	01/24/2014

Similar Medicare Providers

1578560777 — DR. CLINTON DOUGLAS HOLDER M.D.
Practice Location Address:

4604 29TH ST E
PALMETTO, FL
34221-9793

Practice Phone: 941-845-4572
Practice Fax: 941-845-4572

1316397086 — DEBORAH HELENE RICH
Practice Location Address:

3428 70TH GLN E
PALMETTO, FL
34221-7385

Practice Phone: 941-807-4137
Practice Fax:

1043154693 — PALMETTO SPINE AUTO INJURY & PERFORMANCE INSTITUTE, LLC
Practice Location Address:

925 10TH ST E UNIT 925
PALMETTO, FL
34221-4131

Practice Phone: 941-212-4410
Practice Fax:

1063699205 — JOSEPH CHARLES SHIVER D.C.
Practice Location Address:

1611 10TH AVE W
PALMETTO, FL
34221-3018

Practice Phone: 941-721-8132
Practice Fax: 941-721-8232

1982911954 — ALIGN CHIROPRACTIC AND WELLNESS CENTER LLC
Practice Location Address:

1611 10TH AVE W
PALMETTO, FL
34221-3018

Practice Phone: 941-721-8132
Practice Fax: 941-721-8232

1962671107 — NICHOLAS P CONSTANTINE, D.C., P.A.
Practice Location Address:

316 7TH ST W
PALMETTO, FL
34221-5207

Practice Phone: 941-729-3730
Practice Fax: 941-723-9097

Directions to “INFECTIOUS DISEASE CONSULTANTS OF ST. PETERSBURG, P.A. ” 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.