PINELLAS VASCULAR LLC NPI 1174173421

NPI Information

PINELLAS VASCULAR LLC is a vascular surgery surgery in St Petersburg, FL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. PINELLAS VASCULAR LLC NPI is 1174173421. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5880 49TH ST N STE 206
ST PETERSBURG, FL
ZIP 33709-147
Phone: (813) 997-2099

The provider's authorized official is Jeff Mathew .
The authorized official title is President and has the following contact phone number (813) 997-2099.

The CLIA number assigned to this NPI record is 10D2112857 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/18/2019 and was last updated on 10/28/2019.

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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