Organization
ST PETE ENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A GILROY M D (OWNER)
(727) 321-3344
Entity
Organization
Contact information
Practice address
2299 9TH AVE N, SUITE 3B, ST PETERSBURG, FL 33713-6800
(727) 321-3344
(727) 321-3236
Mailing address
2299 9TH AVE N, SUITE 3B, ST PETERSBURG, FL 33713-6800
(727) 321-3344
(727) 321-3236
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME90004
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269742400
—
FL
Enumeration date
10/17/2006
Last updated
03/14/2013
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