Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Diagnostic Clinic Medical Group, Inc

Organization Family Medicine Physician · NPI 1609222405

Diagnostic Clinic Medical Group, Inc is a Family Medicine Physician in St Petersburg, Florida. Registered with an NPI since 2016.

In the registry since
2016
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6776 54th Ave N Ste B
St Petersburg, FL 33709-1405
Phone: (727) 548-8500
Fax: (727) 317-3758
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1609222405
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gina Prebeck — Vp Of Operations · (727) 581-8767
NPI enumeratedMay 11, 2016
Last updated in NPPESNovember 25, 2020
Certification dateNovember 25, 2020
Mailing address6776 54th Ave N, Suite B, St Petersburg, FL 33709-1405

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