| Florida Family Practice & Urgent Care, Llc | |
|
3450 E Fletcher Ave Ste 100 Tampa FL 33613-4603 | |
| (813) 812-4133 | |
| (813) 501-3633 |
| Full Name | Florida Family Practice & Urgent Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3450 E Fletcher Ave Ste 100, Tampa, Florida |
| Authorized Official Name and Position | Ronald Salazar Manalo (PRESIDENT) |
| Authorized Official Contact | 6158385198 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Family Practice & Urgent Care, Llc 3450 E Fletcher Ave Ste 100 Tampa FL 33613-4603 Ph: (813) 812-4133 | Florida Family Practice & Urgent Care, Llc 3450 E Fletcher Ave Ste 100 Tampa FL 33613-4603 Ph: (813) 812-4133 |
| NPI Number | 1710434626 |
|---|---|
| Provider Enumeration Date | 09/08/2016 |
| Last Update Date | 03/11/2019 |
| Medicare PECOS PAC ID | 0446522742 |
|---|---|
| Medicare Enrollment ID | O20170822001377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710434626 | NPI | - | NPPES |
| 019212900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ronald Salazar Manalo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992065049 PECOS PAC ID: 2961668785 Enrollment ID: I20170123000600 |
| Provider Name | Mythily Srigananathan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780194621 PECOS PAC ID: 0244576858 Enrollment ID: I20190117002552 |
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