Provider Demographics
NPI:1871641613
Name:COUNTY OF PINELLAS BOARD OF COUNTY COMMISSIONERS
Entity type:Organization
Organization Name:COUNTY OF PINELLAS BOARD OF COUNTY COMMISSIONERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH CARE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGREGORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-464-8434
Mailing Address - Street 1:440 COURT ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-5139
Mailing Address - Country:US
Mailing Address - Phone:727-464-8434
Mailing Address - Fax:727-464-8454
Practice Address - Street 1:14808 49TH ST N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-2835
Practice Address - Country:US
Practice Address - Phone:727-453-7866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL126385600Medicaid
FL688412100Medicaid