Healthcare Provider Details

I. General information

NPI: 1932306115
Provider Name (Legal Business Name): NADAL MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4019 W WATERS AVE STE #D
TAMPA FL
33614-1949
US

IV. Provider business mailing address

4019 W WATERS AVE STE #D
TAMPA FL
33614
US

V. Phone/Fax

Practice location:
  • Phone: 813-890-9064
  • Fax: 813-890-9813
Mailing address:
  • Phone: 813-890-9064
  • Fax: 813-890-9813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMM13567
License Number StateFL

VIII. Authorized Official

Name: DR. CHUMA G OSUJI
Title or Position: MEDICAL DIRECTOR
Credential: D.O
Phone: 813-890-9064