Healthcare Provider Details

I. General information

NPI: 1124791900
Provider Name (Legal Business Name): JUST MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 09/27/2021
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10320 N 56TH ST STE 100
TEMPLE TERRACE FL
33617-4057
US

IV. Provider business mailing address

10320 N 56TH ST STE 100
TEMPLE TERRACE FL
33617-4057
US

V. Phone/Fax

Practice location:
  • Phone: 813-442-5144
  • Fax: 833-792-1020
Mailing address:
  • Phone: 813-442-5144
  • Fax: 833-792-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BAMIDELE OLATUNBOSUN
Title or Position: PRESIDENT
Credential: MD
Phone: 510-407-4473