Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Diagnostic Clinic Medical Group, Inc

Organization Family Medicine Physician · NPI 1609222405

Diagnostic Clinic Medical Group, Inc provides Family Medicine Physician services 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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