Provider Demographics
NPI:1083069272
Name:PINELLAS NURSING HOME PA
Entity Type:Organization
Organization Name:PINELLAS NURSING HOME PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:JOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-773-8884
Mailing Address - Street 1:2595 TAMPA RD STE D
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3130
Mailing Address - Country:US
Mailing Address - Phone:727-773-8884
Mailing Address - Fax:727-784-5449
Practice Address - Street 1:2595 TAMPA RD STE D
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3130
Practice Address - Country:US
Practice Address - Phone:727-773-8884
Practice Address - Fax:727-784-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty