| Suncoast Mobile Dental Bus Ii | |
|
313 S Lakewood Dr Brandon FL 33511-2815 | |
| (813) 349-7900 | |
| Not Available |
| Full Name | Suncoast Mobile Dental Bus Ii |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 313 S Lakewood Dr, Brandon, Florida |
| Authorized Official Name and Position | Robert Rodriguez (CFO) |
| Authorized Official Contact | 8133497563 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suncoast Mobile Dental Bus Ii 13110 Elk Mountain Dr Riverview FL 33579-7182 Ph: (813) 349-7588 | Suncoast Mobile Dental Bus Ii 313 S Lakewood Dr Brandon FL 33511-2815 Ph: (813) 349-7900 |
| NPI Number | 1427550904 |
|---|---|
| Provider Enumeration Date | 03/01/2018 |
| Last Update Date | 03/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427550904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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