Organization
SUNCOAST MEDICAL CLINIC LLC
Active
Parent organization
SUNCOAST MEDICAL CLINIC LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNCOAST MEDICAL CLINIC LLC
Authorized official
GEROGE L ETTEL M.D. (PRESIDENT)
(727) 894-1818
Entity
Organization
Contact information
Practice address
601 7TH ST S, ST PETERSBURG, FL 33701-4704
(727) 824-8357
(727) 824-3132
Mailing address
601 7TH ST S, ST PETERSBURG, FL 33701-4704
(727) 824-8357
(727) 824-3132
Taxonomy
Speciality
Code
Description
License number
State
261QL0400X
Lithotripsy Clinic/Center
Primary
790
FL
Other
Enumeration date
02/05/2009
Last updated
02/05/2009
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