| Imagine St. Pete | |
|
7348 Us Highway 19 N Pinellas Park FL 33781-4600 | |
| (727) 865-5711 | |
| Not Available |
| Full Name | Imagine St. Pete |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 7348 Us Highway 19 N, Pinellas Park, Florida |
| Authorized Official Name and Position | Mariella Carreno (OFFICE MANAGER) |
| Authorized Official Contact | 8634624463 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imagine St. Pete 11502 N 56th St Temple Terrace FL 33617-2239 Ph: (813) 212-1313 | Imagine St. Pete 7348 Us Highway 19 N Pinellas Park FL 33781-4600 Ph: (727) 865-5711 |
| NPI Number | 1841942489 |
|---|---|
| Provider Enumeration Date | 01/25/2022 |
| Last Update Date | 01/25/2022 |
| Certification Date | 01/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841942489 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | () | Primary |
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