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21507 Village Lakes Shopping Ctr Dr Land O Lakes FL 34639-5101 | |
| (813) 949-4224 | |
| (813) 949-2809 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 21507 Village Lakes Shopping Ctr Dr, Land O Lakes, Florida |
| Authorized Official Name and Position | Gemma Rosello (VICE PRESIDENT) |
| Authorized Official Contact | 3055002000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6101 Blue Lagoon Dr Suite 400 Miami FL 33126-2055 Ph: (305) 500-2114 | 21507 Village Lakes Shopping Ctr Dr Land O Lakes FL 34639-5101 Ph: (813) 949-4224 |
| NPI Number | 1093733701 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 06/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093733701 | NPI | - | NPPES |
| 001887104 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | HCC 5452 (Florida) | Primary |
| 332900000X | Non-pharmacy Dispensing Site | (* (Not Available)) | Secondary |
Florida Medical Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2100 Via Bella Blvd Ste 202, Land O Lakes, FL 34639 Phone: 813-929-3516 | |
Michael A Craven Dc Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5420 Land O Lakes Blvd, Suite 105, Land O Lakes, FL 34639 Phone: 813-996-9800 Fax: 813-996-3326 | |
Verimed Health Group Land O' Lakes, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2638 Narnia Way, Ste 101, Land O Lakes, FL 34638 Phone: 813-909-0760 Fax: 813-949-7394 | |
Dr Kay Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2716 Stonewood Park Loop, Land O Lakes, FL 34638 Phone: 469-915-4211 |