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Organization
ST ANTHONY'S PRIMARY CARE LLC
Active
Organization
ST ANTHONY'S PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN L. CORRIGAN (CAO)
(727) 532-1355
Entity
Organization
Contact information
Practice address
300 PARK PLACE BLVD, SUITE 170, CLEARWATER, FL 33759-4932
(727) 532-1355
(727) 266-4928
Mailing address
PO BOX 1830, CLEARWATER, FL 33757-1830
(727) 532-0002
(727) 266-4928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276113100
—
FL
01
—
DE6358
RAILROAD MEDICARE NUMBER
FL
Enumeration date
05/13/2006
Last updated
06/16/2015
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