| Iditalya 10 Medical Center Inc | |
|
3430 W Lambright St Ste 101 Tampa FL 33614-4750 | |
| (813) 877-4201 | |
| (727) 498-0672 |
| Full Name | Iditalya 10 Medical Center Inc |
|---|---|
| Speciality | General Practice |
| Location | 3430 W Lambright St Ste 101, Tampa, Florida |
| Authorized Official Name and Position | Alfredo Fernandez (OWNER) |
| Authorized Official Contact | 8138774201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iditalya 10 Medical Center Inc 3430 W Lambright St Ste 101 Tampa FL 33614-4750 Ph: (813) 877-4201 | Iditalya 10 Medical Center Inc 3430 W Lambright St Ste 101 Tampa FL 33614-4750 Ph: (813) 877-4201 |
| NPI Number | 1447643291 |
|---|---|
| Provider Enumeration Date | 03/17/2015 |
| Last Update Date | 01/12/2024 |
| Medicare PECOS PAC ID | 3870809510 |
|---|---|
| Medicare Enrollment ID | O20150826001703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447643291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Alfredo Jose Fernandez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912252107 PECOS PAC ID: 1850536475 Enrollment ID: I20130401000381 |
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