MEDICARE: GULF L&D PROFESSIONALS

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1548050610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GULF L&D PROFESSIONALS

Provider Business Mailing Address
First Line	:	3110 W LEROY ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1124
Country	:	US
Telephone Number	:	502-442-1150
Fax Number	:

Provider Business Practice Location Address
First Line	:	3110 W LEROY ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1124
Country	:	US
Telephone Number	:	502-442-1150
Fax Number	:

Authorized Official
Title or Position	:	FNP
Name	:	LUIS FELIX HERNANDEZ SOLER
Credential	:	ARNP
Telephone Number	:	502-442-1150

Provider Enumeration Date	:	05/10/2025
Last Update Date	:	05/10/2025

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Directions to “GULF L&D PROFESSIONALS ” Practice Location

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