Healthcare Provider Details

I. General information

NPI: 1598921900
Provider Name (Legal Business Name): PASCO HMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2008
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 FORT KING RD
DADE CITY FL
33525-5294
US

IV. Provider business mailing address

6120 US HIGHWAY 27 N
SEBRING FL
33870-1221
US

V. Phone/Fax

Practice location:
  • Phone: 352-521-1100
  • Fax: 866-746-1525
Mailing address:
  • Phone: 863-402-0064
  • Fax: 866-746-1525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RICK ROMOLO
Title or Position: MANAGER
Credential:
Phone: 772-538-4047