MEDICARE: INFUCENTERS 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
1	261QI0500X	Infusion Therapy Clinic/Center	PH23311	FL

General Provider Information

NPI Number	:	1912161928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFUCENTERS LLC

Provider Business Mailing Address
First Line	:	5505 JOHNS RD
Second Line	:	SUITE 700
City	:	TAMPA
State	:	FL
Zip	:	33634-4307
Country	:	US
Telephone Number	:	888-744-4638
Fax Number	:	813-549-5490

Provider Business Practice Location Address
First Line	:	5505 JOHNS RD
Second Line	:	SUITE 700
City	:	TAMPA
State	:	FL
Zip	:	33634-4307
Country	:	US
Telephone Number	:	888-744-4638
Fax Number	:	813-549-5490

Authorized Official
Title or Position	:	VP REIMBURSEMENT
Name	:	JOSEPH J POMIS
Credential	:
Telephone Number	:	847-855-6970

Provider Enumeration Date	:	07/18/2008
Last Update Date	:	07/18/2008

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