NPIMap

Organization Active NPI

Suncoast Medical Clinic LLC

  • Durable Medical Equipment & Medical Supplies
  • St Petersburg, FL
National Provider Identifier
1760664882
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SUNCOAST MEDICAL CLINIC LLC
Practice address
1099 5TH Ave N
Ste 130
St Petersburg, FL 33705-1469
Phone
(727) 824-8357
Fax
(727) 824-3132
NPI assigned
Nov 30, 2007
Last updated
May 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Authorized official

Name
Dr. George L. Ettel, M.D.NPI 1619962636
Title
Vice President
Phone
(727) 824-8357

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X FL Primary

Addresses

Primary practice location

1099 5TH Ave N
Ste 130
St Petersburg, FL 33705-1469

Mailing address

1099 5TH Ave N
Suite 130
St Petersburg, FL 33705-1469
Phone (727) 824-8357

National Provider Directory

National Provider Directory

Locations

11465 Ulmerton Rd
Largo, FL 33778
Phone (727) 581-0915

12505 Starkey Rd
Ste B
Largo, FL 33773
Phone (727) 531-8227

30552 US Hwy 19 N
Ste 100
Palm Harbor, FL 34684
Phone (727) 787-6601

7300 Bryan Dairy Rd
Ste 495
Seminole, FL 33777
Phone (727) 451-6780

9555 Seminole Blvd
Ste 101
Seminole, FL 33772
Phone (727) 398-5999

1099 5th Ave N
St Petersburg, FL 33705
Phone (727) 821-1221

1099 5th Ave N
Ste 110
St Petersburg, FL 33705
Phone (727) 820-7800

2100 4th St N
St Petersburg, FL 33704
Phone (727) 822-2361

5425 Park St N
Ste 6W
St Petersburg, FL 33709
Phone (727) 544-9196

5653 Park St N
St Petersburg, FL 33709

7101 Mlk Jr St N
St Petersburg, FL 33702
Phone (727) 527-7231

747 6th Ave S
St Petersburg, FL 33701
Phone (727) 896-2273

Practitioners & affiliated clinicians

Practitioners 85

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.

View all 85

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1760664882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 5TH AVE N",
            "address_2": "SUITE 130",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051469",
            "telephone_number": "727-824-8357",
            "fax_number": "727-824-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 5TH AVE N",
            "address_2": "STE 130",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051469",
            "telephone_number": "727-824-8357",
            "fax_number": "727-824-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "ETTEL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "727-824-8357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": null,
            "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 May 6, 2008; 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.