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General NPI Number Information
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NPI Number | 1457192650
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Entity Type | Organization
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Legal Business Name | OASIS CARE CLINIC INC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 4830 W KENNEDY BLVD STE 600
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City | TAMPA
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State | FL
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Zip | 33609-2584
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Country | US
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Telephone | 813-600-3559
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Fax | 813-602-0896
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Provider Business Mailing Address
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Address Line | 13107 BEE BLOSSOM PL
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City | RIVERVIEW
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State | FL
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Zip | 33579-4080
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER/OWNER
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Name | IMEE MATEO DOWNING
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Credential | APRN
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Telephone | 702-612-5214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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