# NOORANI MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376805168
- **Authorized official:** SARAH PRIMM (OFFICE MANAGER)
- **Authorized official phone:** (813) 571-1111

## Contact information

- **Practice address:** 10924 BLOOMINGDALE AVE, RIVERVIEW, FL 33578-3633
- **Practice address phone:** (813) 571-1111
- **Practice address fax:** (813) 571-1120
- **Mailing address:** 10924 BLOOMINGDALE AVE, RIVERVIEW, FL 33578-3633
- **Mailing address phone:** (813) 571-1111
- **Mailing address fax:** (813) 571-1120

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 36113183 | FL | Yes |

## Other

- **Enumeration date:** 06/08/2012
- **Last updated:** 05/01/2018