Provider Demographics
NPI:1770691404
Name:ARTHUR L. CLEMENTE, MD, PA
Entity type:Organization
Organization Name:ARTHUR L. CLEMENTE, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:CLEMENTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-209-1419
Mailing Address - Street 1:1201 5TH AVENUE N
Mailing Address - Street 2:STE 409
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705
Mailing Address - Country:US
Mailing Address - Phone:727-209-1419
Mailing Address - Fax:
Practice Address - Street 1:1201 5TH AVENUE N
Practice Address - Street 2:STE 409
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705
Practice Address - Country:US
Practice Address - Phone:727-209-1419
Practice Address - Fax:727-209-1659
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARTHUR L. CLEMENTE, MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-25
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87368207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270880900Medicaid
FL270880900Medicaid
H95037Medicare UPIN
FLH95037Medicare UPIN