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General NPI Number Information
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NPI Number | 1912548355
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Entity Type | Organization
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Legal Business Name | AZ MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 10/07/2019
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 3911 W WATERS AVE STE 13
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City | TAMPA
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State | FL
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Zip | 33614-1950
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Country | US
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Telephone | 813-600-3118
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Fax | 813-333-1384
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Provider Business Mailing Address
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Address Line | 3911 W WATERS AVE STE 13
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City | TAMPA
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State | FL
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Zip | 33614-1950
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Country | US
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Telephone | 813-600-3118
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Fax | 813-333-1384
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Authorized Official
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Title or Position | OWNER
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Name | NATALIA LOPEZ
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Credential |
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Telephone | 786-877-4216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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