Organization
PEDIATRIC SURGICAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY CLARK (PRACTICE MANAGER)
(727) 767-3221
Entity
Organization
Contact information
Practice address
880 6TH ST S, SUITE 210, ST PETERSBURG, FL 33701-4827
(727) 767-4170
(727) 767-4346
Mailing address
880 6TH ST S, SUITE 210, ST PETERSBURG, FL 33701-4827
(727) 767-4170
(727) 767-4346
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
ME0055290
FL
Other
Enumeration date
12/14/2005
Last updated
08/22/2020
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