Healthcare Provider Details

I. General information

NPI: 1407765993
Provider Name (Legal Business Name): HUMANITARY MEDICAL CENTER TOWN N COUNTRY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6726 HANLEY RD
TAMPA FL
33634-4739
US

IV. Provider business mailing address

4200 W CYPRESS ST STE 690
TAMPA FL
33607-4112
US

V. Phone/Fax

Practice location:
  • Phone: 813-499-1500
  • Fax: 813-499-1499
Mailing address:
  • Phone: 813-499-1500
  • Fax: 813-499-1499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: ELIECER GONZALEZ
Title or Position: PRESIDENT/CEO
Credential:
Phone: 813-468-1866