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PINNACLE MEDICAL GROUP PA

Clinical Neuropsychologist

Bradenton, Florida

Provider NPI: 1316963077

Organization Information:
Organization Name:  PINNACLE MEDICAL GROUP PA
Organization is not Subpart
Authorized Official:  MARC STEPHEN KALLINS  PRESIDENT  941-7500602

Practice Location:
315 75TH ST W  BRADENTON, FL 34209 US
Tel: 941-761-1998  Fax: 941-761-0395

Business Mailing Address:
315 75TH ST W  BRADENTON, FL 34209 US
Tel: 941-761-1998  Fax: 941-761-0395

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
FLPY6258
N207P00000XPhysicians
Emergency Medicine
FLME34789
Y207Q00000XPhysicians
Family Medicine
FLME13523
N207R00000XPhysicians
Internal Medicine
FLME44610
N207RC0000XPhysicians
Internal Medicine
FLME11749
N207RR0500XPhysicians
Internal Medicine
FLME64188
N207T00000XPhysicians
Neurological Surgery
FLME68033
N207X00000XPhysicians
Orthopaedic Surgery
FLME74784
N208100000XPhysicians
Physical Medicine & Rehabilitation
FLME40567
N2084N0400XPhysicians
Psychiatry & Neurology
FLME72170
N225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
FLPT18064

Other Provider Identifiers:

IssuerNumberStateType
254897604FL05
254897605FL05
254897601FL05
254897602FL05
254897603FL05
BCBS21818FL01
254897600FL05
MEDICARE RAILROADCN7277FL01
MEDICARE RAILROADCH1832FL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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