| Main Street Medical Centers | |
|
10549 N Florida Ave Ste A Tampa FL 33612-6707 | |
| (813) 220-1400 | |
| (813) 440-6484 |
| Full Name | Main Street Medical Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 10549 N Florida Ave Ste A, Tampa, Florida |
| Authorized Official Name and Position | Stephen O Banjoko (CFO) |
| Authorized Official Contact | 2122570225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Medical Centers Po Box 17175 Tampa FL 33682-7175 Ph: (813) 220-1400 | Main Street Medical Centers 10549 N Florida Ave Ste A Tampa FL 33612-6707 Ph: (813) 220-1400 |
| NPI Number | 1487079505 |
|---|---|
| Provider Enumeration Date | 02/26/2014 |
| Last Update Date | 10/03/2024 |
| Medicare PECOS PAC ID | 6709112832 |
|---|---|
| Medicare Enrollment ID | O20190729000315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487079505 | NPI | - | NPPES |
| 104624600 | Medicaid | FL | |
| LK078 | Other | FL | MEDICARE |
| Provider Name | Cheryl A Mclean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780735449 PECOS PAC ID: 7012994668 Enrollment ID: I20040701001223 |
| Provider Name | Gregory F Saric |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952330771 PECOS PAC ID: 6305039934 Enrollment ID: I20101015000088 |
| Provider Name | Unyime J Usoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730698226 PECOS PAC ID: 8224396437 Enrollment ID: I20171218000503 |
| Provider Name | Krystal Np Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730678822 PECOS PAC ID: 1951737451 Enrollment ID: I20200131001156 |
| Provider Name | Ayoola W Olajide |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366920761 PECOS PAC ID: 8426392218 Enrollment ID: I20200325000835 |
| Provider Name | Rizwana Yakub Ismail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962971044 PECOS PAC ID: 8022434380 Enrollment ID: I20200817003475 |
| Provider Name | Chuka Godwin Enebeli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356705677 PECOS PAC ID: 6901216910 Enrollment ID: I20201103001369 |
| Provider Name | Shana Gober |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194324715 PECOS PAC ID: 4688080930 Enrollment ID: I20210316000367 |
Main St Medical Usa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11734 North Dale Mabry, Tampa, FL 33618 Phone: 813-968-6000 Fax: 813-968-6007 | |
Infante Medical Office Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4712 N Armenia Ave, Suite 102, Tampa, FL 33603 Phone: 813-873-1725 Fax: 813-873-2924 | |
After Care Centers Of Florida Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3424 W Kennedy Blvd, Tampa, FL 33609 Phone: 855-716-3342 | |
Eugene A Ward M.d. Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3450 E Fletcher Avenue, Suite 310, Tampa, FL 33613 Phone: 813-972-1654 Fax: 813-972-7176 | |
Sarroca Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3709 W Hamilton Ave, Unit 9., Tampa, FL 33614 Phone: 813-374-7608 Fax: 813-374-9124 | |
Simmons Medical Group South Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 301 Harbour Place Dr Unit 2007, Tampa, FL 33602 Phone: 248-321-6612 Fax: 813-964-6337 | |
N/a Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3225 S Macdill Ave Ste 129-313, Tampa, FL 33629 Phone: 813-200-8857 Fax: 813-200-1319 |