Organization
MPM SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN L. CORRIGAN (CAO)
(727) 532-1355
Entity
Organization
Contact information
Practice address
300 PARK PLACE BLVD, SUITE 170, CLEARWATER, FL 33759-4932
(727) 532-1355
(727) 266-4928
Mailing address
PO BOX 10744, CLEARWATER, FL 33757-8744
(727) 532-0002
(727) 266-4928
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
133V00000X
Registered Dietitian
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275066000
—
FL
01
—
DD7747
RAILROAD MEDICARE NUMBER
FL
Enumeration date
05/24/2006
Last updated
02/14/2015
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