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General NPI Number Information
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NPI Number | 1760916696
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Entity Type | Organization
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Legal Business Name | 360 DEGREE MEDICAL CARE PA
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 3111 W SAN JOSE ST
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City | TAMPA
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State | FL
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Zip | 33629-7247
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Country | US
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Telephone | 813-446-5460
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Fax |
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Provider Business Mailing Address
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Address Line | 3111 W SAN JOSE ST
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City | TAMPA
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State | FL
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Zip | 33629-7247
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Country | US
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Telephone | 813-446-5460
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DR. RENA MEHTA
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Credential | MD
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Telephone | 813-446-5460
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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 |
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License Number State |
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