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General NPI Number Information
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NPI Number | 1396550430
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Entity Type | Organization
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Legal Business Name | INERTIA MEDICAL CENTER LLC.
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 6704 E FOWLER AVE
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-2410
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Country | US
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Telephone | 813-899-4440
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Fax | 813-980-1225
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Provider Business Mailing Address
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Address Line | 6704 E FOWLER AVE
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-2410
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Country | US
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Telephone | 813-899-4440
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Fax | 813-980-1225
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Authorized Official
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Title or Position | OWNER
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Name | CRYSTIAN JOSE MARTINEZ
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Credential |
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Telephone | 813-380-8716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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