Provider Demographics
NPI:1942334248
Name:CLEARWATER NATURAL MEDICAL CENTER
Entity Type:Organization
Organization Name:CLEARWATER NATURAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:O NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:727-726-7333
Mailing Address - Street 1:2454 N MCMULLEN BOOTH RD STE 609
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1337
Mailing Address - Country:US
Mailing Address - Phone:727-726-7333
Mailing Address - Fax:
Practice Address - Street 1:2454 N MCMULLEN BOOTH RD STE 609
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1337
Practice Address - Country:US
Practice Address - Phone:727-726-7333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP0000269171100000X
FLAP1655171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB0093OtherBLUE CROSS
FLB0862OtherBLUE CROSS