| Phoenix Medical Clinic | |
|
6408 N Armenia Ave Ste B-1 Tampa FL 33604-5770 | |
| (813) 352-8305 | |
| Not Available |
| Full Name | Phoenix Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 6408 N Armenia Ave Ste B-1, Tampa, Florida |
| Authorized Official Name and Position | Ricardo A Gomez Fernandez (ADMINISTRATOR) |
| Authorized Official Contact | 8133528305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Medical Clinic 6408 N Armenia Ave Ste B-1 Tampa FL 33604-5770 Ph: () - | Phoenix Medical Clinic 6408 N Armenia Ave Ste B-1 Tampa FL 33604-5770 Ph: (813) 352-8305 |
| NPI Number | 1528624053 |
|---|---|
| Provider Enumeration Date | 05/09/2019 |
| Last Update Date | 10/10/2022 |
| Medicare PECOS PAC ID | 7315279593 |
|---|---|
| Medicare Enrollment ID | O20191022001277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528624053 | NPI | - | NPPES |
| Provider Name | Jose Ernesto Alvarez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548313950 PECOS PAC ID: 8527225473 Enrollment ID: I20120203000194 |
| Provider Name | Deysi Aguilera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538487046 PECOS PAC ID: 5991982449 Enrollment ID: I20160729000764 |
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