NPIMap

Organization Active NPI

Innovacare Central Florida Physicians, LLC

Doing business as Anchor Medical Group

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1275200248
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INNOVACARE CENTRAL FLORIDA PHYSICIANS, LLC
Doing business as
Anchor Medical Group
Practice address
1111 7TH Ave N Ste 107
Saint Petersburg, FL 33705-1348
Phone
(727) 894-1661
NPI assigned
Aug 26, 2021
Organization subpart
Yes
Parent organization
INNOVACARE CENTRAL FLORIDA PHYSICIANS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
Dwight Perez
Title
Credentialing Specialist
Phone
(305) 733-7513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1111 7TH Ave N Ste 107
Saint Petersburg, FL 33705-1348

Mailing address

1111 7TH Ave N Ste 107
Saint Petersburg, FL 33705-1348
Phone (727) 894-1661

Other names 1

  • Anchor Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Innovacare Central Florida Physicians LLC7 organizations share this tax ID, including this one
Part of
Innovacare Central Florida Physicians LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1275200248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 7TH AVE N STE 107",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337051348",
            "telephone_number": "727-894-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 7TH AVE N STE 107",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337051348",
            "telephone_number": "727-894-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVACARE CENTRAL FLORIDA PHYSICIANS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INNOVACARE CENTRAL FLORIDA PHYSICIANS, LLC",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "305-733-7513"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anchor Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.