| Your Place Health System Llc | |
|
1793 W Hillsborough Ave Tampa FL 33603-1130 | |
| (813) 443-0866 | |
| (813) 225-1583 |
| Full Name | Your Place Health System Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1793 W Hillsborough Ave, Tampa, Florida |
| Authorized Official Name and Position | Sydel Y Legrande (OWNER) |
| Authorized Official Contact | 8134430866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Place Health System Llc 1793 W Hillsborough Ave Tampa FL 33603-1130 Ph: (813) 443-0866 | Your Place Health System Llc 1793 W Hillsborough Ave Tampa FL 33603-1130 Ph: (813) 443-0866 |
| NPI Number | 1801129119 |
|---|---|
| Provider Enumeration Date | 09/18/2009 |
| Last Update Date | 10/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801129119 | NPI | - | NPPES |
| CY926A | Other | FL | P-TAN |
| PENDING | Medicaid | FL | |
| D44801 | Other | UPIN # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME47234 (Florida) | Primary |
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