1205954666 NPI number — PAUTLER COHEN FINDLAY EICHENBAUM WHITE AND CRANE MDS PA

Table of content: (NPI 1205954666)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205954666 NPI number — PAUTLER COHEN FINDLAY EICHENBAUM WHITE AND CRANE MDS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAUTLER COHEN FINDLAY EICHENBAUM WHITE AND CRANE MDS PA
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:
6
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:
1205954666
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4344 CENTRAL AVE
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:
33711-1141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-323-0077
Provider Business Mailing Address Fax Number:
727-323-7627

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4344 CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33711-1141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-323-0077
Provider Business Practice Location Address Fax Number:
727-323-7627
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PAUTLER
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
JANE
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
813-879-5795

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207WX0107X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: CB2164 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: DD4629 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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