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NPI Code Detail

MEDICARE: SUNCOAST COMMUNITY HEALTH CENTERS INC

MEDICARE: SUNCOAST COMMUNITY HEALTH CENTERS 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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

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

General Provider Information

NPI Number : 1578573085
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNCOAST COMMUNITY HEALTH CENTERS INC
Provider Business Mailing Address
First Line : 13110 ELK MOUNTAIN DR
Second Line :
City : RIVERVIEW
State : FL
Zip : 33579-7182
Country : US
Telephone Number : 813-349-7588
Fax Number : 813-349-7596
Provider Business Practice Location Address
First Line : 801 E BAKER ST
Second Line :
City : PLANT CITY
State : FL
Zip : 33563-3652
Country : US
Telephone Number : 813-349-7600
Fax Number : 813-349-7661
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : ROBERT RODRIGUEZ
Credential :
Telephone Number : 813-349-7563
Provider Enumeration Date : 08/08/2006
Last Update Date : 12/08/2022

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Directions to “SUNCOAST COMMUNITY HEALTH CENTERS INC ” Practice Location

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