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THE CLINIC ST PETE
NPI 1730637877
Internal Medicine - Addiction Medicine in St Petersburg, FL

Active since September 19, 2016
4100 5TH AVE N, ST PETERSBURG, FL 33713(845) 608-3312 Get Directions Write a Review

NPPES record last updated: September 19, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About The Clinic St Pete NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE CLINIC ST PETE (NPI 1730637877) is a healthcare organization registered as an addiction medicine in St Petersburg, Florida and active in the NPI registry since September 2016. The organization lists Nicole Ackerman, Ceo, as its authorized official.

NPPES Registry Identity

NPI1730637877
Entity TypeOrganization
Primary Taxonomy207RA0401X
Legal Business NameTHE CLINIC ST PETE
Location Address4100 5TH AVE NSt Petersburg, FL 33713-6304
Mailing Address11 Plaza Real S Apt 1003Boca Raton, FL 33432-4899 · (845) 608-3312
Phone(845) 608-3312
Organization SubpartNo
Authorized OfficialNicole AckermanCeo · (845) 608-3312
Enumeration DateSeptember 19, 2016
✔ NPI 1730637877 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RA0401X
Definition
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
4100 5TH AVE N, St Petersburg, FL 33713
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Clinic St Pete's NPI number?

The NPI number for The Clinic St Pete is 1730637877. It was assigned to this organization in the NPPES registry on September 19, 2016.

Where is The Clinic St Pete located?

The Clinic St Pete is located at 4100 5th Ave N, St Petersburg, FL 33713. The listed phone number is (845) 608-3312.

What is The Clinic St Pete's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

When was this NPI record last updated?

The NPPES record for The Clinic St Pete was last updated on September 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.