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7320 E Fletcher Ave Tampa FL 33637-0916 | |
| (813) 498-9378 | |
| (813) 441-8534 |
| Full Name | |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 7320 E Fletcher Ave, Tampa, Florida |
| Authorized Official Name and Position | Esther Mugomba-bird (OWNER) |
| Authorized Official Contact | 2398416373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
7320 E Fletcher Ave Tampa FL 33637-0916 Ph: (813) 498-9378 | 7320 E Fletcher Ave Tampa FL 33637-0916 Ph: (813) 498-9378 |
| NPI Number | 1306535620 |
|---|---|
| Provider Enumeration Date | 05/03/2023 |
| Last Update Date | 10/12/2023 |
| Certification Date | 10/12/2023 |
| Medicare PECOS PAC ID | 8820450893 |
|---|---|
| Medicare Enrollment ID | O20230809000207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306535620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Esther Mugomba-bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639504400 PECOS PAC ID: 1658501358 Enrollment ID: I20140225000810 |
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