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Organization
MEDICAL CENTER ON THE GULF LLC
Active
Organization
MEDICAL CENTER ON THE GULF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANANDA SOM MD (CHAIRMAN)
(727) 738-0220
Entity
Organization
Contact information
Practice address
30522 US 19 N STE 109, PALM HARBOR, FL 34684-4436
(727) 738-0220
(727) 734-7072
Mailing address
PO BOX 1921, DUNEDIN, FL 34697-1921
(727) 738-0220
(727) 734-7072
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0407698
UNITED HEALTHCARE
—
01
—
110239219
RAILROAD MEDICARE
—
01
—
1627837
FIRST HEALTH
—
01
—
213422
AMERIGROUP
—
01
—
244046
AVMED
—
05
—
254433400
—
FL
01
—
3087332
CIGNA
—
01
—
410972
TUFTS HEALTH PLAN
—
01
—
43705
BLUE CROSS BLUE SHIELD
—
01
—
5306646
AETNA
—
01
—
K8814
GRP #
—
01
—
P2746142
OXFORD HEALTH INSURANCE
—
Enumeration date
02/21/2006
Last updated
07/13/2015
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