Provider Demographics
NPI:1215910260
Name:COMMUNITY HOSPITALISTS OF PINELLA
Entity type:Organization
Organization Name:COMMUNITY HOSPITALISTS OF PINELLA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUCHAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-441-1451
Mailing Address - Street 1:613 S MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-5615
Mailing Address - Country:US
Mailing Address - Phone:727-441-1451
Mailing Address - Fax:727-446-9528
Practice Address - Street 1:613 S MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5615
Practice Address - Country:US
Practice Address - Phone:727-441-1451
Practice Address - Fax:727-446-9528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268904900Medicaid
FL268904900Medicaid