Organization
ST MARY'S PEDIATRIC CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EID GUIRGUIS MD (OWNER)
(727) 754-1984
Entity
Organization
Contact information
Practice address
2626 TAMPA RD, SUITE 101, PALM HARBOR, FL 34684-3155
(727) 754-1984
(727) 754-2868
Mailing address
2626 TAMPA RD, SUITE 101, PALM HARBOR, FL 34684-3155
(727) 754-1984
(727) 754-2868
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME105372
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015657
—
FL
Enumeration date
11/26/2014
Last updated
11/26/2014
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