Individual
DR. CLINTON C. PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
2815 W VIRGINIA AVE, STE A, TAMPA, FL 33607-6357
(855) 834-6911
(813) 443-5600
Mailing address
1099 SHIPWATCH CIR, TAMPA, FL 33602-5736
(855) 834-6911
(813) 443-5600
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
ME0064760
FL
2085R0202X
Diagnostic Radiology Physician
ME0064760
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME64760
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1159488
WELLCARE
FL
01
—
170612
SUNSHINE
FL
01
—
23826
BCBS
FL
05
—
375122800
—
FL
01
—
4602329
AETNA
FL
01
—
P01549711
MEDICARE RAILROAD
FL
Enumeration date
11/04/2005
Last updated
05/04/2016
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