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Organization
PINNACLE MEDICAL GROUP PA
Active
Organization
PINNACLE MEDICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC STEPHEN KALLINS M.D. (PRESIDENT)
(941) 750-0602
Entity
Organization
Contact information
Practice address
315 75TH ST W, BRADENTON, FL 34209-3201
(941) 761-1998
(941) 761-0395
Mailing address
315 75TH ST W, BRADENTON, FL 34209-3201
(941) 761-1998
(941) 761-0395
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PY6258
FL
207P00000X
Emergency Medicine Physician
ME34789
FL
207Q00000X
Family Medicine Physician
Primary
ME13523
FL
207R00000X
Internal Medicine Physician
ME44610
FL
207RC0000X
Cardiovascular Disease Physician
ME11749
FL
207RR0500X
Rheumatology Physician
ME64188
FL
207T00000X
Neurological Surgery Physician
ME68033
FL
207X00000X
Orthopaedic Surgery Physician
ME74784
FL
208100000X
Physical Medicine & Rehabilitation Physician
ME40567
FL
2084N0400X
Neurology Physician
ME72170
FL
225100000X
Physical Therapist
PT18064
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21818
BCBS
FL
05
—
254897600
—
FL
05
—
254897601
—
FL
05
—
254897602
—
FL
05
—
254897603
—
FL
05
—
254897604
—
FL
05
—
254897605
—
FL
01
—
CH1832
MEDICARE RAILROAD
FL
01
—
CN7277
MEDICARE RAILROAD
FL
Enumeration date
07/15/2006
Last updated
07/16/2010
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