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NPI Code Detail

MEDICARE: HUMANITARY MEDICAL CENTER, INC.

MEDICARE: HUMANITARY MEDICAL CENTER, 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
1261QP2300XPrimary Care Clinic/Center

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 : 1629612668
Entity Type Code : Organization
Provider Name (Legal Business Name) : HUMANITARY MEDICAL CENTER, INC.
Provider Business Mailing Address
First Line : 6607 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33614-3985
Country : US
Telephone Number : 813-499-1500
Fax Number : 813-499-1499
Provider Business Practice Location Address
First Line : 6607 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33614-3985
Country : US
Telephone Number :
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. ELIECER GONZALEZ
Credential : MD
Telephone Number : 813-499-1500
Provider Enumeration Date : 11/02/2019
Last Update Date : 06/09/2023

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Directions to “HUMANITARY MEDICAL CENTER, INC. ” Practice Location

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