| Promedix Direct | |
|
7901 4th St N Ste 300 St Petersburg FL 33702-4399 | |
| (949) 506-0640 | |
| Not Available |
| Full Name | Promedix Direct |
|---|---|
| Speciality | Internal Medicine |
| Location | 7901 4th St N Ste 300, St Petersburg, Florida |
| Authorized Official Name and Position | Ira Beer (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9495060640 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Promedix Direct 7901 4th St N Ste 300 St Petersburg FL 33702-4399 Ph: (949) 793-7000 | Promedix Direct 7901 4th St N Ste 300 St Petersburg FL 33702-4399 Ph: (949) 506-0640 |
| NPI Number | 1649086331 |
|---|---|
| Provider Enumeration Date | 12/06/2024 |
| Last Update Date | 12/08/2025 |
| Certification Date | 12/08/2025 |
| Medicare PECOS PAC ID | 8325530892 |
|---|---|
| Medicare Enrollment ID | O20251121003101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649086331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Gregory Robertson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932281011 PECOS PAC ID: 2961571245 Enrollment ID: I20120323000136 |
| Provider Name | Lashika Meanus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528673233 PECOS PAC ID: 6103235452 Enrollment ID: I20221019000954 |
| Provider Name | Mira Brahmbhatt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891348165 PECOS PAC ID: 5092143222 Enrollment ID: I20251201002930 |
| Provider Name | Mireya Bustamante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992541668 PECOS PAC ID: 6608305180 Enrollment ID: I20251208003338 |
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