MEDICARE: HEALTHCARE CENTER OF TAMPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP3300X	Pain Clinic/Center	M0070224	FL

General Provider Information

NPI Number	:	1235117649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE CENTER OF TAMPA

Provider Business Mailing Address
First Line	:	202 PARKVIEW PL
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-4548
Country	:	US
Telephone Number	:	863-682-7246
Fax Number	:	863-682-5566

Provider Business Practice Location Address
First Line	:	202 PARKVIEW PL
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-4548
Country	:	US
Telephone Number	:	863-682-7246
Fax Number	:	863-682-5566

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	STEPHANIE MARIE LOMSAK
Credential	:
Telephone Number	:	863-682-7246

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	08/22/2020

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Directions to “HEALTHCARE CENTER OF TAMPA ” Practice Location

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