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NPI Code Detail

MEDICARE: FLORIDA CLINICAL QUALITY PHYSICIANS INC.

MEDICARE: FLORIDA CLINICAL QUALITY PHYSICIANS INC.
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
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1649780354
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA CLINICAL QUALITY PHYSICIANS INC.
Provider Business Mailing Address
First Line : 2202 N WEST SHORE BLVD STE 200
Second Line :
City : TAMPA
State : FL
Zip : 33607-5749
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2202 N WEST SHORE BLVD STE 200
Second Line :
City : TAMPA
State : FL
Zip : 33607-5749
Country : US
Telephone Number : 813-639-4296
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. TOM WECKERLE
Credential :
Telephone Number : 813-639-4296
Provider Enumeration Date : 10/08/2017
Last Update Date : 10/08/2017

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Directions to “FLORIDA CLINICAL QUALITY PHYSICIANS INC. ” Practice Location

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