# SUNCOAST COMMUNITY HEALTH CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brandon Community Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417556275
- **Authorized official:** ROBERT RODRIGUEZ (CFO)
- **Authorized official phone:** (813) 349-7563

## Contact information

- **Practice address:** 313 S LAKEWOOD DR, BRANDON, FL 33511-2815
- **Practice address phone:** (913) 349-7900
- **Practice address fax:** (888) 853-7318
- **Mailing address:** 13110 ELK MOUNTAIN DR, RIVERVIEW, FL 33579-7182
- **Mailing address phone:** (813) 349-7588
- **Mailing address fax:** (813) 349-7596

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 10/22/2020
- **Last updated:** 11/03/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 029557428 | — | FL |