Basic Information
| Provider Information | |||||||||
| NPI: | 1245385095 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERICAN CARE OF TAMPA INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11255 SW 211TH ST | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331892240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052780200 | ||||||||
| FaxNumber: | 7862350145 | ||||||||
| Practice Location | |||||||||
| Address1: | 11211 N NEBRASKA AVE | ||||||||
| Address2: | SUITE A-5 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336125777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8135142333 | ||||||||
| FaxNumber: | 8135142216 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2007 | ||||||||
| LastUpdateDate: | 10/16/2012 | ||||||||
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| AuthorizedOfficialLastName: | GARCIA | ||||||||
| AuthorizedOfficialFirstName: | JOSE | ||||||||
| AuthorizedOfficialMiddleName: | E. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 3052780200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.