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General NPI Number Information
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NPI Number | 1780485979
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Entity Type | Organization
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Legal Business Name | E&E MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 5237 EHRLICH RD
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City | TAMPA
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State | FL
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Zip | 33624-2042
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Country | US
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Telephone | 813-506-4769
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Fax |
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Provider Business Mailing Address
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Address Line | 13926 HENSON CIR
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City | TAMPA
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State | FL
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Zip | 33625-3121
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Country | US
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Telephone | 813-451-3171
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MILAGROS VIRGINIA VAZQUEZ GUACH
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Credential | ARNP
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Telephone | 813-451-3171
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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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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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