1649619958 NPI number — NAMI PINELLAS COUNTY, FLORIDA, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649619958 NPI number — NAMI PINELLAS COUNTY, FLORIDA, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NAMI PINELLAS COUNTY, FLORIDA, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649619958
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 12773
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST PETERSBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33733-2773
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-791-3434
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8800 49TH ST N
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
PINELLAS PARK
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33782-5353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-791-3434
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/19/2013

Additional Information

Authorized Official

Authorized Official Last Name:
HAWK
Authorized Official First Name:
ELLEN
Authorized Official Middle Name:
GAY
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
727-272-3270

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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