| Wimauma Community Health Center | |
|
16621 Lagoon Shore Blvd Wimauma FL 33598-4177 | |
| (813) 349-7880 | |
| Not Available |
| Full Name | Wimauma Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 16621 Lagoon Shore Blvd, Wimauma, Florida |
| Authorized Official Name and Position | Robert R Rodriguez (CFO) |
| Authorized Official Contact | 8133497563 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wimauma Community Health Center 13110 Elk Mountain Dr Riverview FL 33579-7182 Ph: (813) 349-7588 | Wimauma Community Health Center 16621 Lagoon Shore Blvd Wimauma FL 33598-4177 Ph: (813) 349-7880 |
| NPI Number | 1518388354 |
|---|---|
| Provider Enumeration Date | 12/20/2013 |
| Last Update Date | 07/14/2022 |
| Medicare PECOS PAC ID | 3870402548 |
|---|---|
| Medicare Enrollment ID | O20140807000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518388354 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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