MEDICARE: ALPHAPROMED, LLC

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
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1588237333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHAPROMED, LLC

Provider Business Mailing Address
First Line	:	6201 JOHNS RD STE 9
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-4434
Country	:	US
Telephone Number	:	813-439-9638
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 HARBOUR PLACE DR UNIT 1204
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-6799
Country	:	US
Telephone Number	:	813-439-9638
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HUMBERTO ARGUELLO
Credential	:
Telephone Number	:	813-439-9638

Provider Enumeration Date	:	07/20/2021
Last Update Date	:	07/20/2021

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Directions to “ALPHAPROMED, LLC ” Practice Location

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