| Jose R. Foradada, Iii, Md, P.a. | |
|
4710 N. Habana Ave. Suite 307 Tampa FL 33614-7151 | |
| (813) 874-2000 | |
| Not Available |
| Full Name | Jose R. Foradada, Iii, Md, P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4710 N. Habana Ave., Tampa, Florida |
| Authorized Official Name and Position | Jose Ramon Foradada (PRESIDENT) |
| Authorized Official Contact | 8138742000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jose R. Foradada, Iii, Md, P.a. 4710 N. Habana Ave. Suite 307 Tampa FL 33614-7151 Ph: (813) 874-2000 | Jose R. Foradada, Iii, Md, P.a. 4710 N. Habana Ave. Suite 307 Tampa FL 33614-7151 Ph: (813) 874-2000 |
| NPI Number | 1164766002 |
|---|---|
| Provider Enumeration Date | 11/15/2012 |
| Last Update Date | 11/15/2012 |
| Medicare PECOS PAC ID | 6800048166 |
|---|---|
| Medicare Enrollment ID | O20121212000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164766002 | NPI | - | NPPES |
| 273113400 | Other | FL | MEDICAID GROUP |
| 062490000 | Medicaid | FL |
| Provider Name | Jose R Foradada |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841308475 PECOS PAC ID: 8628065745 Enrollment ID: I20040429000386 |
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