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General NPI Number Information
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NPI Number | 1043536022
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Entity Type | Organization
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Legal Business Name | FL MEDICAL CENTER OF NEW PORT RICHEY PA
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 4648 GRAND BLVD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-5113
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Country | US
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Telephone | 727-842-7397
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Fax | 727-842-7790
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Provider Business Mailing Address
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Address Line | 4648 GRAND BLVD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-5113
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Country | US
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Telephone | 727-842-7397
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Fax | 727-842-7790
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. NANCY R. WERT
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Credential | OFFICE MANAGER
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Telephone | 727-842-7397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0050514
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License Number State | FL
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