| Medi Clinics Primary Care Llc | |
|
502 S Macdill Ave Tampa FL 33609-3039 | |
| (813) 465-9999 | |
| (813) 831-6292 |
| Full Name | Medi Clinics Primary Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 502 S Macdill Ave, Tampa, Florida |
| Authorized Official Name and Position | Venkata Jaya Pratap Bireddy (OWNER/ADMINISTRATOR) |
| Authorized Official Contact | 8134659999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medi Clinics Primary Care Llc 502 S Macdill Ave Tampa FL 33609-3039 Ph: (813) 465-9999 | Medi Clinics Primary Care Llc 502 S Macdill Ave Tampa FL 33609-3039 Ph: (813) 465-9999 |
| NPI Number | 1609120534 |
|---|---|
| Provider Enumeration Date | 10/30/2012 |
| Last Update Date | 01/19/2024 |
| Medicare PECOS PAC ID | 6608029152 |
|---|---|
| Medicare Enrollment ID | O20130111000041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609120534 | NPI | - | NPPES |
| Provider Name | Venkata J Bireddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891815387 PECOS PAC ID: 2163519919 Enrollment ID: I20071026000255 |
| Provider Name | Rathinam Moorthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962594747 PECOS PAC ID: 0749356715 Enrollment ID: I20080828000167 |
| Provider Name | Nizarali Visram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548312051 PECOS PAC ID: 1355333634 Enrollment ID: I20231225000055 |
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