Provider Demographics
NPI:1326159310
Name:THE CLINIC OF PEDIATRICS & GI MEDICINE, INC.
Entity type:Organization
Organization Name:THE CLINIC OF PEDIATRICS & GI MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZEINOMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-913-1666
Mailing Address - Street 1:102 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4907
Mailing Address - Country:US
Mailing Address - Phone:850-913-1666
Mailing Address - Fax:850-913-1549
Practice Address - Street 1:102 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4907
Practice Address - Country:US
Practice Address - Phone:850-913-1666
Practice Address - Fax:850-913-1549
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CLINIC OF PEDIATRICS AND GI MEDICINE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Multi-Specialty