Provider Demographics
NPI:1285765040
Name:PINELLAS MEDICAL ASSOCIATES, PA
Entity type:Organization
Organization Name:PINELLAS MEDICAL ASSOCIATES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLAHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-528-6100
Mailing Address - Street 1:5880 49TH ST N
Mailing Address - Street 2:STE 104
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2150
Mailing Address - Country:US
Mailing Address - Phone:727-528-6100
Mailing Address - Fax:727-528-7895
Practice Address - Street 1:5880 49TH ST N STE 104
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2142
Practice Address - Country:US
Practice Address - Phone:727-528-6100
Practice Address - Fax:727-528-7895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9206207XS0117X, 207XS0117X
FLPA910479363AM0700X
207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019534200Medicaid
FL269694100Medicaid
FL064484600Medicaid
FL269660600Medicaid
FLK8068Medicare ID - Type Unspecified
FL019534200Medicaid
FL6078850001Medicare NSC
FL43227XMedicare PIN
FLI09733Medicare UPIN
FL43227VMedicare PIN
FL43183YMedicare PIN
FL6440380001Medicare NSC
FLIV096ZMedicare PIN
FL82874AMedicare PIN
FL269660600Medicaid