ST. PETERSBURG FREE CLINIC (NPI# 1366945099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366945099 |
| Entity Type | Organization |
| Organization Name | ST. PETERSBURG FREE CLINIC |
| Practice Address |
5501 - 4th Street North St. Petersburg FL 33703 |
| Practice Telephone | 7273270333 |
| Practice Fax Number | 7273216412 |
| Mailing Telephone | 7273270333 |
| Mailing Fax Number | 7273216412 |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-03-08 |
| Authorized Official Name | MS. BETH ANNE HOUGHTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7278237866 |
| Authorized Official Credential | MBA, JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
5501 - 4TH STREET NORTH |
| City | ST. PETERSBURG |
| State | FL |
| Zip Code | 33703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376150276 | Stephanie Gayle Barnes | Rehabilitation Practitioner | 610 47th Ave N, St Petersburg, FL 33703 | 2020-09-25 |
| 1306381363 | Dominique Timothee | Behavioral Analyst | 4301 16th Street N, St Petersburg, FL 33703 | 2016-12-30 |
| 1962849455 | Bobbie Vaughn | Behavioral Analyst | 880 6th St. South, St. Petersburg, FL 33703 | 2013-05-24 |
| 1255672796 | Mary Paige Bourbeau | Nurse Practitioner | 5500 9th St N., St Petersburg, FL 33703 | 2013-03-07 |
| 1437435237 | Lynn Bonner-nelson | Counselor | 6161 Dr. Mlk Jr Street N. #204, Saint Petersburg, FL 33703 | 2011-10-25 |
| 1245545953 | Patricia Reynolds | Speech-Language Pathologist | 3950 3rd Street North, Suite D, Community Rehab Associates, St. Petersburg, Fl, FL 33703 | 2010-08-18 |
| 1326367145 | Sigurd T Rutkis | Occupational Therapist | 3835 1st Street Northeast, St. Petersburg, FL 33703 | 2010-05-18 |
| 1922338136 | Christy Carr | Mechanotherapist | 5560 Kelly Dr N, Saint Petersburg, FL 33703 | 2010-01-11 |
| 1871730317 | Ronald H Copenhaver Dmd Pa | Dentist | 4338 1st Street N, Suite C, St. Petersburg, FL 33703 | 2009-01-20 |
| 1598902280 | Thomas Paulantonio D.c., P.a. | Chiropractor | 5001 Fourth Street North, St. Petersburg, FL 33703 | 2009-01-16 |
| Find all providers in zip 33703 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215358981 | Jacqueline Blutcher Gollman | General Practice | 205 Martin Luther King, Jr. St. No., Pinellas County Health Department, St. Petersburg, FL 33701-3109 | 2013-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033823 | Bless Medical Center of Nmb LLC | General Practice | 1400 Ne Miami Gardens Dr Ste 209, North Miami Beach, FL 33179-4844 | 2020-11-02 |
| 1982203634 | Central Florida Wellness LLC | General Practice | 15516 W Colonial Dr Ste 111, Winter Garden, FL 34787-9558 | 2020-10-23 |
| 1760080212 | Summit Health Multi Specialty of Florida LLC | General Practice | 1881 W Kennedy Blvd Ste D, Tampa, FL 33606-1611 | 2020-10-15 |
| 1376140772 | Amy Wrenn | General Practice | 155 Cranes Roost Blvd Ste 2020-a, Altamonte Springs, FL 32701-3468 | 2020-10-08 |
| 1992302574 | Avita Medical Clinic, LLC | General Practice | 14831 N Florida Ave, Tampa, FL 33613-1825 | 2020-10-06 |
| 1568069672 | Ernesto Oscar Gonzalez Pupo | General Practice | 14420 Sw 22nd St, Miami, FL 33175-6338 | 2020-10-02 |
| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
| 1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | ST. PETERSBURG |
| Zip Code | 33703 |
Please comment or provide details below to improve the information on ST. PETERSBURG FREE CLINIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.