| St Joseph's Community Care Inc | |
|
3550 W Waters Ave Ste 110 Tampa FL 33614-2767 | |
| (813) 886-8899 | |
| Not Available |
| Full Name | St Joseph's Community Care Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3550 W Waters Ave Ste 110, Tampa, Florida |
| Authorized Official Name and Position | Lynda Gorken (VP) |
| Authorized Official Contact | 7272819202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Joseph's Community Care Inc 3550 W Waters Ave Ste 110 Tampa FL 33614-2767 Ph: (813) 886-8899 | St Joseph's Community Care Inc 3550 W Waters Ave Ste 110 Tampa FL 33614-2767 Ph: (813) 886-8899 |
| NPI Number | 1003946591 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 02/09/2022 |
| Medicare PECOS PAC ID | 8527046150 |
|---|---|
| Medicare Enrollment ID | O20040710000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003946591 | NPI | - | NPPES |
| 372550201 | Medicaid | FL | |
| 3725502-00 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shahla Amrooei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922089838 PECOS PAC ID: 6507882586 Enrollment ID: I20051019000392 |
| Provider Name | Mary I Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891799128 PECOS PAC ID: 0547332744 Enrollment ID: I20080703000228 |
| Provider Name | Colleen E Bartlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265750996 PECOS PAC ID: 3870754096 Enrollment ID: I20120416000638 |
| Provider Name | Eisy Earl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356790455 PECOS PAC ID: 6507150158 Enrollment ID: I20160804002351 |
| Provider Name | Jessica Einwag Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194367136 PECOS PAC ID: 8123454964 Enrollment ID: I20200214000708 |
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