MEDICARE: MEDICAL CARE CENTERS, LLC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1427202324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL CARE CENTERS, LLC

Provider Business Mailing Address
First Line	:	6916 W LINEBAUGH AVE
Second Line	:	SUITE 101
City	:	TAMPA
State	:	FL
Zip	:	33625-5800
Country	:	US
Telephone Number	:	813-968-5300
Fax Number	:

Provider Business Practice Location Address
First Line	:	6916 W LINEBAUGH AVE
Second Line	:	SUITE 101
City	:	TAMPA
State	:	FL
Zip	:	33625-5800
Country	:	US
Telephone Number	:	813-968-5300
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	NAMRATA A AMIN
Credential	:
Telephone Number	:	813-968-5300

Provider Enumeration Date	:	11/05/2008
Last Update Date	:	11/05/2008

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