Provider Demographics
NPI:1598181539
Name:PINELLAS COUNTY PHYSICAL MEDICINE LLC
Entity Type:Organization
Organization Name:PINELLAS COUNTY PHYSICAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAMPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-823-6089
Mailing Address - Street 1:407 N BELCHER RD
Mailing Address - Street 2:4
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-2608
Mailing Address - Country:US
Mailing Address - Phone:727-791-9355
Mailing Address - Fax:
Practice Address - Street 1:407 N BELCHER RD
Practice Address - Street 2:4
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-2608
Practice Address - Country:US
Practice Address - Phone:727-791-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty