# PEDIATRIC SURGICAL GROUP, P.A.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033194816
- **Authorized official:** MRS. CATHY CLARK (PRACTICE MANAGER)
- **Authorized official phone:** (727) 767-3221

## Contact information

- **Practice address:** 880 6TH ST S, SUITE 210, ST PETERSBURG, FL 33701-4827
- **Practice address phone:** (727) 767-4170
- **Practice address fax:** (727) 767-4346
- **Mailing address:** 880 6TH ST S, SUITE 210, ST PETERSBURG, FL 33701-4827
- **Mailing address phone:** (727) 767-4170
- **Mailing address fax:** (727) 767-4346

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | ME0055290 | FL | Yes |

## Other

- **Enumeration date:** 12/14/2005
- **Last updated:** 08/22/2020