Organization
ST. ANTHONY'S 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) 532-0002
(727) 266-4928
Mailing address
PO BOX 1829, CLEARWATER, FL 33757-1829
(727) 532-0002
(727) 266-4928
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279784400
—
FL
01
—
DN0852
MEDICARE RAILROAD PROVIDER GROUP NUMBER
—
Enumeration date
06/16/2006
Last updated
06/16/2015
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