OrganizationActive
Diagnostic Clinic Medical Group Inc.
NPI 1780080945 · Family Medicine Physician · St Petersburg, FL
Provider details
- NPI number
- 1780080945
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Gina Prebeck, Vp of Operations(727) 581-8767
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
630 Pasadena Ave S
St Petersburg, FL 33707-2128
Phone: (727) 345-7100
Fax: (727) 345-7102
Street-level locationGet directions
Mailing address
630 Pasadena Ave S
St Petersburg, FL 33707-2128
Registry dates
- Enumerated
- 2014-11-14
- Last updated
- 2020-11-25
- Certified
- 2020-11-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.