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NPI Code Detail

MEDICARE: FLORIDA FAMILY PRACTICE & URGENT CARE, LLC

MEDICARE: FLORIDA FAMILY PRACTICE & URGENT CARE, 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 Physician

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 : 1710434626
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA FAMILY PRACTICE & URGENT CARE, LLC
Provider Business Mailing Address
First Line : 3450 E FLETCHER AVE STE 100
Second Line :
City : TAMPA
State : FL
Zip : 33613-4603
Country : US
Telephone Number : 813-812-4133
Fax Number : 813-501-3633
Provider Business Practice Location Address
First Line : 3450 E FLETCHER AVE STE 100
Second Line :
City : TAMPA
State : FL
Zip : 33613-4603
Country : US
Telephone Number : 813-812-4133
Fax Number : 813-501-3633
Authorized Official
Title or Position : PRESIDENT
Name : DR. RONALD SALAZAR MANALO
Credential : M.D.
Telephone Number : 615-838-5198
Provider Enumeration Date : 09/08/2016
Last Update Date : 03/11/2019

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Practice Location Address:
3450 E FLETCHER AVE STE 110
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33613-4603
Practice Phone: 813-972-4488
Practice Fax: 813-972-3996
1407842461 — DR. AMY L SOLOMON MD
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1952397911 — DR. SONJA L PERKINS MD
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33613-4603
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Practice Fax: 813-972-3996
1710388814 — ANA MARIA FRAGUADA
Practice Location Address:
3450 E FLETCHER AVE STE 110
TAMPA, FL
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1831579465 — ELIZABETH GIANGRECO M.D.
Practice Location Address:
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1023725207 — CLAIRMISE FREDERIC APRN
Practice Location Address:
3450 E FLETCHER AVE STE 110
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Directions to “FLORIDA FAMILY PRACTICE & URGENT CARE, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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