OrganizationActive
The Clinic St Pete
NPI 1730637877 · Addiction Medicine (Internal Medicine) Physician · St Petersburg, FL
Provider details
- NPI number
- 1730637877
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Nicole Ackerman, Ceo(845) 608-3312
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
4100 5th Ave N
St Petersburg, FL 33713-6304
Phone: (845) 608-3312
Approximate (ZIP-level) locationGet directions
Mailing address
11 Plaza Real S Apt 1003
Boca Raton, FL 33432-4899
Registry dates
- Enumerated
- 2016-09-19
- Last updated
- 2016-09-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.