Diagnostic Clinic Medical Group, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DIAGNOSTIC CLINIC MEDICAL GROUP, INC.

Practice address

1301 2ND Ave SW
Largo, FL 33770-3120

Phone

(727) 581-8767

Fax

(727) 581-8507

NPI assigned

Oct 5, 2009

Last updated

Nov 25, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gina M Prebeck

Title

VP of Operationa

Phone

(727) 581-8767

Specialties & licenses 9

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Diagnostic Clinic Medical Group Inc.

  • Internal Medicine Physician
  • Clearwater, FL
  • NPI 1699927616

  Member Of

  NPD member

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1457686784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 2ND AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703120",
            "telephone_number": "727-581-8767",
            "fax_number": "727-581-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 2ND AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703120",
            "telephone_number": "727-581-8767",
            "fax_number": "727-581-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC CLINIC MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-05",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "PREBECK",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP OF OPERATIONA",
        "authorized_official_telephone_number": "727-581-8767"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260094300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diabetes and More, Inc. (Choice Diabetic Supply)
• Diabetes Dimensions
• Diagnostic Clinic Medical Group Inc.
• Diagnostic Clinic Medical Group Inc. (Diagnostic Clinic)
• Diagnostic Clinic Medical Group, Inc.
• Diagnostic Clinic Medical Group, Inc.
• Diagnostic Clinic Medical Group, PA
• Vasilios Frank Diakonis, MD
• Megan Diamond, OTR/L
• Jesus Diaz Vera

• Internal Medicine Physician in Largo, FL
• Providers in Largo, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.