Active NPI
Verimed Health Group Pinellas Park, LLC
- Internal Medicine Physician
- St Petersburg, FL
National Provider Identifier
1043441546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- OS8908
- Legal business name
- VERIMED HEALTH GROUP PINELLAS PARK, LLC
- Practice address
- 12450 Roosevelt Blvd N Ste 308
St Petersburg, FL 33716-1902 - Phone
- (727) 577-0285
- Fax
- (727) 577-3870
- NPI assigned
- Jul 31, 2009
- Last updated
- Jan 22, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Julissa Ortiz
- Title
- Assistant Administrator
- Phone
- (727) 577-0285
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OS8908 | FL | Primary |
Addresses
Primary practice location
12450 Roosevelt Blvd N Ste 308
St Petersburg, FL 33716-1902
Mailing address
12450 Roosevelt Blvd N
St Petersburg, FL 33716-1902
Phone (727) 577-0285
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2030 E Speedway Blvd
Ste 118
Tucson, AZ 85719
Phone (520) 268-4609
9365 US Highway 19 N
Ste E
Pinellas Park, FL 33782
Phone (727) 577-0285
12450 Roosevelt Blvd N
St Petersburg, FL 33716
Phone (727) 571-1688
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Physician
- St Petersburg, FL
- NPI 1881292373
-
- Family Medicine Physician
- Largo, FL
- NPI 1245530443
-
- Family Medicine Physician
- Largo, FL
- NPI 1538166269
-
- Specialist
- Tampa, FL
- NPI 1013020338
-
- General Practice Physician
- Tampa, FL
- NPI 1962548032
-
- Internal Medicine Physician
- Pinellas Park, FL
- NPI 1447394416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674345600000",
"number": "1043441546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12450 ROOSEVELT BLVD N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337161902",
"telephone_number": "727-577-0285",
"fax_number": "727-577-3870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12450 ROOSEVELT BLVD N STE 308",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337161902",
"telephone_number": "727-577-0285",
"fax_number": "727-577-3870"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VERIMED HEALTH GROUP PINELLAS PARK, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-07-31",
"last_updated": "2023-01-22",
"certification_date": "2023-01-22",
"status": "A",
"authorized_official_last_name": "ORTIZ",
"authorized_official_first_name": "JULISSA",
"authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
"authorized_official_telephone_number": "727-577-0285"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "OS8908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.