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NPI Code Detail

MEDICARE: CARIBE HEALTH CENTER

MEDICARE: CARIBE HEALTH CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistHCC7615FL

General Provider Information

NPI Number : 1174895668
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARIBE HEALTH CENTER
Provider Business Mailing Address
First Line : 4812 N HABANA AVE
Second Line : SUITE A
City : TAMPA
State : FL
Zip : 33614-6871
Country : US
Telephone Number : 813-873-1392
Fax Number : 813-873-1394
Provider Business Practice Location Address
First Line : 4812 N HABANA AVE
Second Line : SUITE A
City : TAMPA
State : FL
Zip : 33614-6871
Country : US
Telephone Number : 813-873-1392
Fax Number : 813-873-1394
Authorized Official
Title or Position : OWNER
Name : MS. SUREYA DIAZ
Credential :
Telephone Number : 813-873-1392
Provider Enumeration Date : 01/31/2012
Last Update Date : 01/31/2012

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Directions to “CARIBE HEALTH CENTER ” Practice Location

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