Suncoast Medical Clinic LLC
Durable Medical Equipment & Medical Supplies in St Petersburg, FL. Organization (NPI-2).
NPI number1760664882
StatusActive
Last updated in NPPESMay 6, 2008
Details
- NPI
- 1760664882
- Entity type
- Organization (NPI-2)
- Legal business name
- Suncoast Medical Clinic LLC
- Organization subpart
- No
- Enumeration date
- Nov 30, 2007
- Last updated
- May 6, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | FL | Yes |
Practice location
1099 5th Ave NSte 130
St Petersburg, FL 33705-1469
Phone 727-824-8357 · Fax 727-824-3132
Mailing address
1099 5th Ave NSuite 130
St Petersburg, FL 33705-1469
Phone 727-824-8357 · Fax 727-824-3132
Authorized official
George L. Ettel
Vice President
7278248357
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