Provider Demographics
NPI:1073033940
Name:PATIENT PHYSICIAN SERVICES LLC
Entity Type:Organization
Organization Name:PATIENT PHYSICIAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:HOPKINS-HOCKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-954-7642
Mailing Address - Street 1:14100 US HIGHWAY 19 N STE 132
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-7220
Mailing Address - Country:US
Mailing Address - Phone:727-954-7642
Mailing Address - Fax:727-898-9596
Practice Address - Street 1:14100 US HIGHWAY 19 N STE 132
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-7220
Practice Address - Country:US
Practice Address - Phone:727-954-7642
Practice Address - Fax:727-898-9596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2081P2900X, 261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty