# PREMIUM HEALTH SERVICES OF TAMPA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** express care of tampa bay
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790060366
- **Authorized official:** DR. KHAWAJA A RAHMAN MD (PRESIDENT)
- **Authorized official phone:** (813) 651-4100

## Contact information

- **Practice address:** 107 W ROBERTSON ST, BRANDON, FL 33511-5111
- **Practice address phone:** (813) 651-4100
- **Practice address fax:** (813) 651-4111
- **Mailing address:** 6015 REX HALL LN, APOLLO BEACH, FL 33572-2657
- **Mailing address phone:** (813) 690-7589

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | ME79013 | FL | Yes |

## Other

- **Enumeration date:** 10/14/2011
- **Last updated:** 10/14/2011