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NPI Code Detail

MEDICARE: URGICARE TAMPA, LLC

MEDICARE: URGICARE TAMPA, 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
1207Q00000XFamily Medicine Physician242580FL

General Provider Information

NPI Number : 1609174358
Entity Type Code : Organization
Provider Name (Legal Business Name) : URGICARE TAMPA, LLC
Provider Business Mailing Address
First Line : PO BOX 1666
Second Line :
City : BRANDON
State : FL
Zip : 33509-1666
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3345 S DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33629-7817
Country : US
Telephone Number : 813-831-7722
Fax Number : 813-381-7766
Authorized Official
Title or Position : MANAGER
Name : MR. ZULF GOKAK
Credential :
Telephone Number : 813-397-7566
Provider Enumeration Date : 03/04/2011
Last Update Date : 05/10/2011

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