PEDIATRIC SURGICAL GROUP P.A. NPI 1033194816

NPI Information

PEDIATRIC SURGICAL GROUP, P.A. is a pediatric surgery surgery in St Petersburg, FL. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. PEDIATRIC SURGICAL GROUP, P.A. NPI is 1033194816. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

880 6TH ST S
SUITE 210
ST PETERSBURG, FL
ZIP 33701-827
Phone: (727) 767-4170
Fax: (727) 767-4346

The provider's authorized official is Cathy Clark .
The authorized official title is Practice Manager and has the following contact phone number (727) 767-3221.

The CLIA number assigned to this NPI record is 10D2024540 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2005 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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