Organization Active NPI

P3 Health Partners-Florida LLC

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1922643261
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
P3 HEALTH PARTNERS-FLORIDA LLC
Practice address
5425 Park St N Ste 7W
St Petersburg, FL 33709-7042
Phone
(727) 202-8140
Fax
(727) 202-8252
NPI assigned
Nov 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Authorized official

Name
Amir Bacchus, MD
Title
Cmo
Phone
(702) 910-3950

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

5425 Park St N Ste 7W
St Petersburg, FL 33709-7042

Mailing address

2370 Corporate Cir Ste 300
Henderson, NV 89074-7760
Phone (702) 910-3950

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2190488P3 Health Partners-Florida LLC5425 Park St N - Ste 7W, Saint Petersburg, FL 33709Certificate of waiverAug 13, 2026

National Provider Directory

National Provider Directory

Locations

13501 Icot Blvd
Ste 114
Clearwater, FL 33760
Phone (727) 754-7880

13501 Icot Blvd
Ste 112
Clearwater, FL 33760

2202 N West Shore Blvd
Ste 251
Tampa, FL 33607
Phone (702) 910-3950

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1922643261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 CORPORATE CIR STE 300",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747760",
            "telephone_number": "702-910-3950",
            "fax_number": "702-778-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 PARK ST N STE 7W",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337097042",
            "telephone_number": "727-202-8140",
            "fax_number": "727-202-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P3 HEALTH PARTNERS-FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-11",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "BACCHUS",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "702-910-3950",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.