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Organization
PREMIUM HEALTH SERVICES OF TAMPA
Active
Organization
PREMIUM HEALTH SERVICES OF TAMPA
Active
Other names
express care of tampa bay
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHAWAJA A RAHMAN MD (PRESIDENT)
(813) 651-4100
Entity
Organization
Contact information
Practice address
107 W ROBERTSON ST, BRANDON, FL 33511-5111
(813) 651-4100
(813) 651-4111
Mailing address
6015 REX HALL LN, APOLLO BEACH, FL 33572-2657
(813) 690-7589
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
ME79013
FL
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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