Samuel, Jibin Valiyaveettil

Samuel, Jibin Valiyaveettil is an individual health care provider with primary practice located at 501 6Th Ave S , St Petersburg FL 33701-4634. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pediatric Anesthesiology is his primary health care specialty. Samuel, Jibin Valiyaveettil can be contacted via phone (727) 767-8480.

Contact Information

Primary practice address
501 6Th Ave S St Petersburg FL 33701-4634
Fax: (727) 767-8420
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Anesthesiology 207LP3000X ME104317 Florida
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X ME104317 Florida

Profile Details

NPI number 1841432291
LBN Legal business name Samuel, Jibin Valiyaveettil
Credentials MBBS
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2009
Last updated Jan 18th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841432291 NPPES
Florida MEDICAID 002338900

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