| Florida Medical Practice | |
|
19007 Bruce B. Downs Blvd. Tampa FL 33647 | |
| (813) 907-0233 | |
| (813) 907-0064 |
| Full Name | Florida Medical Practice |
|---|---|
| Speciality | Pediatrics |
| Location | 19007 Bruce B. Downs Blvd., Tampa, Florida |
| Authorized Official Name and Position | Gautham Sampath (ADMINISTRATOR) |
| Authorized Official Contact | 8139070233 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Medical Practice 19007 Bruce B. Downs Blvd. Tampa FL 33647 Ph: (813) 907-0233 | Florida Medical Practice 19007 Bruce B. Downs Blvd. Tampa FL 33647 Ph: (813) 907-0233 |
| NPI Number | 1811216286 |
|---|---|
| Provider Enumeration Date | 05/25/2010 |
| Last Update Date | 05/25/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811216286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 208000000X | Pediatrics | () | Primary |
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