PEDIATRIC SURGICAL GROUP P.A. NPI 1033194816

NPI Information

  • NPI: 1033194816
  • Provider Name: PEDIATRIC SURGICAL GROUP, P.A.
  • Classification: Surgery - 2086S0120X
  • Specialization: Pediatric Surgery
  • Entity Type: Organization
  • CLIA Number: 10D2024540
  • Address: 880 6TH ST S
    SUITE 210
    ST PETERSBURG, FL
    ZIP 33701
  • Phone: (727) 767-4170

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NPI Details

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0120XSurgeryPediatric SurgeryME0055290FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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