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Organization
RAG MEDICAL CLINIC LLC
Active
Organization
RAG MEDICAL CLINIC LLC
Active
Other names
Phoenix Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO A GOMEZ FERNANDEZ (ADMINISTRATOR)
(813) 352-8305
Entity
Organization
Contact information
Practice address
6408 N ARMENIA AVE STE B-1, TAMPA, FL 33604-5770
(813) 352-8305
Mailing address
6408 N ARMENIA AVE STE B-1, TAMPA, FL 33604-5770
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
NULL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
261QP2300X
Primary Care Clinic/Center
—
NULL
261QP3300X
Pain Clinic/Center
—
NULL
Other
Enumeration date
05/09/2019
Last updated
01/14/2026
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