Provider Demographics
NPI:1760712848
Name:FLORIDA MED CLINIC OF CLEARWATER, INC.
Entity Type:Organization
Organization Name:FLORIDA MED CLINIC OF CLEARWATER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIFI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-442-3001
Mailing Address - Street 1:1840 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-2138
Mailing Address - Country:US
Mailing Address - Phone:727-442-3001
Mailing Address - Fax:727-467-9106
Practice Address - Street 1:1840 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-2138
Practice Address - Country:US
Practice Address - Phone:727-442-3001
Practice Address - Fax:727-467-9106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL152W00000X, 207R00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251380300Medicaid
FL40847OtherBLUE SHIELD
FL40847Medicare PIN