Organization Active NPI

Eos Regenerative Aesthetic Medicine

  • Internal Medicine Physician
  • Saint Petersburg, FL
National Provider Identifier
1861382376
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EOS REGENERATIVE AESTHETIC MEDICINE
Practice address
2059 Central Ave
Saint Petersburg, FL 33713-8814
Phone
(813) 789-3464
NPI assigned
Jul 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
Stacy Ribeiro
Title
Partner
Phone
(813) 510-0096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2059 Central Ave
Saint Petersburg, FL 33713-8814

Mailing address

2059 Central Ave
Saint Petersburg, FL 33713-8814
Phone (813) 789-3464

Other names 1

  • Tres Beaux Apothecary Former legal business name

National Provider Directory

National Provider Directory

Locations

2059 Central Ave
Saint Petersburg, FL 33713
Phone (813) 789-3464

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1861382376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2059 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337138814",
            "telephone_number": "813-789-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2059 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337138814",
            "telephone_number": "813-789-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EOS REGENERATIVE AESTHETIC MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "RIBEIRO",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "813-510-0096"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tres Beaux Apothecary",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jul 7, 2025; 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.