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16521 S Us Highway 301 Wimauma FL 33598-2032 | |
(813) 925-1903 | |
(813) 749-8370 |
Full Name | |
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Speciality | General Practice |
Location | 16521 S Us Highway 301, Wimauma, Florida |
Authorized Official Name and Position | Daron G. Diecidue (MEMBER MANAGER) |
Authorized Official Contact | 8139251903 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 15490 Scottsdale AZ 85267-5490 Ph: (318) 424-4008 | 16521 S Us Highway 301 Wimauma FL 33598-2032 Ph: (813) 925-1903 |
NPI Number | 1407413974 |
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Provider Enumeration Date | 05/21/2019 |
Last Update Date | 12/09/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407413974 | NPI | - | NPPES |
104160305 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
Rocks And Roses Optimal Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16915 Scuba Crest St, Wimauma, FL 33598 Phone: 901-201-1963 | |
Shahul Hameed Riazudeen Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16541 S Us Highway 301, Wimauma, FL 33598 Phone: 813-633-1100 Fax: 813-633-1152 | |
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