| Cargo 28 Inc | |
|
1700 66th St N Ste 304 St Petersburg FL 33710-5500 | |
| (202) 517-3677 | |
| Not Available |
| Full Name | Cargo 28 Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1700 66th St N Ste 304, St Petersburg, Florida |
| Authorized Official Name and Position | Roberto Pujol (PRESIDENT) |
| Authorized Official Contact | 2025173677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cargo 28 Inc 1700 66th St N Ste 304 St Petersburg FL 33710-5500 Ph: (202) 517-3677 | Cargo 28 Inc 1700 66th St N Ste 304 St Petersburg FL 33710-5500 Ph: (202) 517-3677 |
| NPI Number | 1417802695 |
|---|---|
| Provider Enumeration Date | 03/03/2026 |
| Last Update Date | 03/03/2026 |
| Certification Date | 03/03/2026 |
| Medicare PECOS PAC ID | 2163994211 |
|---|---|
| Medicare Enrollment ID | O20260618004548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417802695 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (NU) | Secondary |
| Provider Name | Fred E Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609022086 PECOS PAC ID: 5092851212 Enrollment ID: I20091001000480 |
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