# FLORIDA MEDICAL CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FLORIDA MEDICAL CLINIC, LLC
- **Other names:** Florida Medical Clinic Pathology Lab
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003036237
- **Legal business name:** FLORIDA MEDICAL CLINIC, LLC
- **Authorized official:** JOE I DELATORRE (CEO)
- **Authorized official phone:** (813) 780-8440

## Contact information

- **Practice address:** 17401 COMMERCE PARK BLVD STE 108, TAMPA, FL 33647-3507
- **Practice address phone:** (813) 782-8311
- **Mailing address:** 38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
- **Mailing address phone:** (813) 780-1255
- **Mailing address fax:** (813) 780-9773

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |
| 207ZP0105X | Clinical Pathology/Laboratory Medicine Physician | — | NULL | — |
| 207ZP0105X | Clinical Pathology/Laboratory Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 04/30/2007
- **Last updated:** 02/21/2020