| Sq2 Primary Care | |
|
13172 N Dale Mabry Hwy Tampa FL 33618-2406 | |
| (813) 374-8981 | |
| (813) 521-7422 |
| Full Name | Sq2 Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 13172 N Dale Mabry Hwy, Tampa, Florida |
| Authorized Official Name and Position | Qilin Lu (OWNER) |
| Authorized Official Contact | 8133748981 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sq2 Primary Care 13172 N Dale Mabry Hwy Tampa FL 33618-2406 Ph: (813) 374-8981 | Sq2 Primary Care 13172 N Dale Mabry Hwy Tampa FL 33618-2406 Ph: (813) 374-8981 |
| NPI Number | 1427659002 |
|---|---|
| Provider Enumeration Date | 11/02/2020 |
| Last Update Date | 08/15/2024 |
| Medicare PECOS PAC ID | 7315354271 |
|---|---|
| Medicare Enrollment ID | O20210322001630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427659002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Qilin Lu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467749119 PECOS PAC ID: 4981841822 Enrollment ID: I20210322001717 |
| Provider Name | Mutinta Yvonne Tembo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003575523 PECOS PAC ID: 1658762943 Enrollment ID: I20211221001030 |
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