| Medical Home Pl | |
|
4401 4th St N Saint Petersburg FL 33703-4728 | |
| (727) 525-4401 | |
| (727) 525-7788 |
| Full Name | Medical Home Pl |
|---|---|
| Speciality | Clinic/Center |
| Location | 4401 4th St N, Saint Petersburg, Florida |
| Authorized Official Name and Position | Fred Elton Clark (OWNER) |
| Authorized Official Contact | 7275254401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Home Pl Po Box 7651 Saint Petersburg FL 33734-7651 Ph: (727) 922-0009 | Medical Home Pl 4401 4th St N Saint Petersburg FL 33703-4728 Ph: (727) 525-4401 |
| NPI Number | 1629485271 |
|---|---|
| Provider Enumeration Date | 07/16/2014 |
| Last Update Date | 06/11/2022 |
| Medicare PECOS PAC ID | 3274803259 |
|---|---|
| Medicare Enrollment ID | O20170725000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629485271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME102187 (Florida) | Primary |
| Provider Name | Fred E Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609022086 PECOS PAC ID: 5092851212 Enrollment ID: I20091001000480 |
| Provider Name | Sarah V Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528896354 PECOS PAC ID: 4587187661 Enrollment ID: I20250329000117 |
Metropolitan Charities Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 625 6th Ave S Ste 305, Saint Petersburg, FL 33701 Phone: 727-321-3854 Fax: 727-327-7670 | |
Kelly Venuti, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1631 Dr Martin Luther King Jr St N, Saint Petersburg, FL 33704 Phone: 727-275-7550 | |
Viamyo Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 1st Ave S Ste 200, Saint Petersburg, FL 33701 Phone: 727-308-9848 | |
Innovative Wound Care Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3051 Tech Dr N Ste 100, Saint Petersburg, FL 33716 Phone: 855-819-6863 | |
Truescan Mri Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5015 4th St N, Saint Petersburg, FL 33703 Phone: 727-709-5058 | |
Gulf Coast Internist, Llc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4957 38th Ave N, Suite C, Saint Petersburg, FL 33710 Phone: 727-525-0900 Fax: 727-525-9500 | |
Premier Health Care Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 218 Pasadena Ave S, Saint Petersburg, FL 33707 Phone: 727-345-0160 |