Diagnostic Clinic Medical Group, Inc.

LBN: Diagnostic Clinic Medical Group, Inc.
Diagnostic Clinic Medical Group, Inc. is an health care organization with primary practice located at 1615 Pasadena Ave S Ste 220 , South Pasadena FL 33707-4517. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Diagnostic Clinic Medical Group, Inc. can be contacted via phone (727) 345-7100, or through Prebeck, Gina Marie via phone (727) 559-9461.

Contact Information

Primary practice address
1615 Pasadena Ave S Ste 220 South Pasadena FL 33707-4517
Phone: (727) 345-7100
Fax: (727) 345-7102
Website:
Map and Directions
Authorized official contact:
Name: Prebeck, Gina Marie
Phone: (727) 559-9461

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1851997985
LBN Legal business name Diagnostic Clinic Medical Group, Inc.
DBA Doing business as
Authorized official Prebeck, Gina Marie
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 4th, 2020
Last updated Mar 16th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851997985 NPPES
Florida Other 00036 FLORIDA BLUE

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