Organization Active NPI

Humanitary Medical Center Pinellas, Inc

  • Primary Care Clinic/Center
  • Pinellas Park, FL
National Provider Identifier
1033864343
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HUMANITARY MEDICAL CENTER PINELLAS, INC
Practice address
6500 66TH St N
Pinellas Park, FL 33781-5030
Phone
(813) 499-1500
Fax
(813) 499-1499
NPI assigned
Feb 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Eliecer Gonzalez
Title
President
Phone
(813) 468-1866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

6500 66TH St N
Pinellas Park, FL 33781-5030

Mailing address

6500 66TH St N
Pinellas Park, FL 33781-5030
Phone (813) 499-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250622000029 FL Part B Supplier - Clinic/Group Practice 9638681190 Receives reassigned benefits from 4 practitioners
Practice locations: Pinellas Park, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2257470Humanitary Medical Center Pinellas, Inc6500 66TH St N, Pinellas Park, FL 33781Certificate of waiverApr 5, 2028

National Provider Directory

National Provider Directory

Locations

6500 66th St N
Pinellas Park, FL 33781
Phone (727) 347-1286

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1033864343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 66TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337815030",
            "telephone_number": "813-499-1500",
            "fax_number": "813-499-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 66TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337815030",
            "telephone_number": "813-499-1500",
            "fax_number": "813-499-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMANITARY MEDICAL CENTER PINELLAS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-15",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ELIECER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-468-1866",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.