| |
7108 Causeway Blvd, Tampa, FL 33619-6364 | |
(813) 628-4400 | |
(813) 628-4500 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Primary Care |
Location | 7108 Causeway Blvd, Tampa, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447461355 | NPI | - | NPPES |
061216200 | Medicaid | FL |
Provider Name | Dency Rivas |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1861493900 PECOS PAC ID: 6204025315 Enrollment ID: I20110105000672 |
Provider Name | Marilin M Hernandez Rodriguez |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1437594306 PECOS PAC ID: 1254551245 Enrollment ID: I20141222000835 |
Provider Name | Yanet D Perez-parra |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942642301 PECOS PAC ID: 4789908062 Enrollment ID: I20150114001458 |
Mailing Address | Practice Location Address |
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7108 Causeway Blvd, Tampa, FL 33619-6364 Ph: (813) 628-4400 | 7108 Causeway Blvd, Tampa, FL 33619-6364 Ph: (813) 628-4400 |