Suncoast Medical Clinic Llc

LBN: Suncoast Medical Clinic Llc
Suncoast Medical Clinic Llc is an health care organization with primary practice located at 601 7Th St S , St Petersburg FL 33701-4704. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Suncoast Medical Clinic Llc can be contacted via phone (727) 824-8357, or through Ettel, George L. via phone (727) 824-8357.

Contact Information

Primary practice address
601 7Th St S St Petersburg FL 33701-4704
Phone: (727) 824-8357
Fax: (727) 824-3132
Website:
Map and Directions
Authorized official contact:
Name: Ettel, George L. Doctor of Medicine (MD)
Phone: (727) 824-8357

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 790 Florida

Profile Details

NPI number 1821115841
LBN Legal business name Suncoast Medical Clinic Llc
DBA Doing business as
Authorized official Ettel, George L. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 23rd, 2007
Last updated May 5th, 2008 - about 16 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 1821115841 NPPES
Florida Other 790 STATE LICENSE
Florida MEDICAID 079192000 STATE LICENSE

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