Organization
DIAGNOSTIC CLINIC MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA M PREBECK (VP OF OPERATIONS)
(727) 581-8767
Entity
Organization
Contact information
Practice address
6776 54TH AVE N, SUITE B, ST PETERSBURG, FL 33709-1405
(727) 548-8500
(727) 317-3758
Mailing address
6776 54TH AVE N, SUITE B, ST PETERSBURG, FL 33709-1405
(727) 548-8500
(727) 317-3758
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/11/2016
Last updated
11/25/2020
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