Organization
MEDICAL SPECIALTY CLINICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY J GORDON (MGRM)
(352) 239-4659
Entity
Organization
Contact information
Practice address
860 S VILLAGE DR N, 105, ST PETERSBURG, FL 33716-3024
(352) 239-4659
Mailing address
860 S VILLAGE DR N, 105, ST PETERSBURG, FL 33716-3024
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/20/2010
Last updated
10/21/2010
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