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General NPI Number Information
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NPI Number | 1073868790
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Entity Type | Organization
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Legal Business Name | SUNCOAST COMMUNITY HEALTH CENTERS, INC
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 14254 MARTIN LUTHER KING BLVD
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City | DOVER
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State | FL
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Zip | 33527-4414
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Country | US
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Telephone | 813-349-7700
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Fax | 813-349-7761
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Provider Business Mailing Address
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Address Line | 13110 ELK MOUNTAIN DR
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City | RIVERVIEW
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State | FL
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Zip | 33579-7182
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Country | US
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Telephone | 813-349-7563
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Fax | 813-349-7596
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | ROBERT R RODRIGUEZ
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Credential |
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Telephone | 813-349-7569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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