Healthcare Provider Details
I. General information
NPI: 1841700697
Provider Name (Legal Business Name): ACCESS MEDICAL GROUP OF TAMPA II, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2017
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4054 W HILLSBOROUGH AVE
TAMPA FL
33614-5617
US
IV. Provider business mailing address
6100 BLUE LAGOON DR STE 365
MIAMI FL
33126-7010
US
V. Phone/Fax
- Phone: 813-906-1412
- Fax: 813-413-1971
- Phone: 786-322-7333
- Fax: 786-322-7329
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
RAYNY
RAMIREZ
Title or Position: PRESIDENT
Credential:
Phone: 786-322-7333