MEDICARE: CITRUS HEALTH CARE, INC

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	302R00000X	Health Maintenance Organization

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386652980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITRUS HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	5420 BAY CENTER DR
Second Line	:	SUITE 250
City	:	TAMPA
State	:	FL
Zip	:	33609-3436
Country	:	US
Telephone Number	:	813-490-8900
Fax Number	:

Provider Business Practice Location Address
First Line	:	5420 BAY CENTER DR
Second Line	:	SUITE 250
City	:	TAMPA
State	:	FL
Zip	:	33609-3436
Country	:	US
Telephone Number	:	813-490-8900
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VP MEDICAL DIRECTOR
Name	:	MR. JAYANT PATEL
Credential	:	MD
Telephone Number	:	813-490-8900

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/11/2008

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