Individual provider Active NPI

Raisa Hodzic

  • Developmental Disabilities Clinic/Center
  • Saint Petersburg, FL
National Provider Identifier
1457829293
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Practice address
1532 62ND Ave N
Saint Petersburg, FL 33702-7338
Phone
(727) 459-0062
NPI assigned
Nov 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

1532 62ND Ave N
Saint Petersburg, FL 33702-7338

Mailing address

365 114TH Ave N Unit 4
Saint Petersburg, FL 33716-2826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1457829293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 114TH AVE N UNIT 4",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337162826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 62ND AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337027338",
            "telephone_number": "727-459-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODZIC",
        "first_name": "RAISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-09",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.