| Divine Medical Center, Inc | |
|
6107 Memorial Hwy Ste B Tampa FL 33615-4564 | |
| (813) 810-8650 | |
| Not Available |
| Full Name | Divine Medical Center, Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 6107 Memorial Hwy Ste B, Tampa, Florida |
| Authorized Official Name and Position | Gelys Gongora (PRESIDENT) |
| Authorized Official Contact | 8138108650 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Medical Center, Inc 6107 Memorial Hwy Ste B Tampa FL 33615-4564 Ph: (813) 810-8650 | Divine Medical Center, Inc 6107 Memorial Hwy Ste B Tampa FL 33615-4564 Ph: (813) 810-8650 |
| NPI Number | 1275348526 |
|---|---|
| Provider Enumeration Date | 02/12/2025 |
| Last Update Date | 02/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275348526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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