Organization
CAPITAL MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS FRIEDRICH (VP OPERATIONS AND BUS DEVELOPMENT)
(727) 408-3232
Entity
Organization
Contact information
Practice address
5985 49TH ST N, ST PETERSBURG, FL 33709-2111
(727) 408-3232
(727) 527-3715
Mailing address
PO BOX 3377, PINELLAS PARK, FL 33780-3377
(727) 408-3232
(727) 527-3715
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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