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Organization

NEW TAMPA MEDICAL CLINIC LLC

Active
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Organization

NEW TAMPA MEDICAL CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUVARNA NOMULA M.D (CEO)
(813) 994-9995
Entity
Organization

Contact information

Practice address
20431 BRUCE B DOWNS BLVD, TAMPA, FL 33647-2759
(813) 994-9995
(813) 994-8019
Mailing address
20431 BRUCE B DOWNS BLVD, TAMPA, FL 33647-2759
(813) 994-9995
(813) 994-8019

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME85978
FL

Other

Enumeration date
12/26/2007
Last updated
04/19/2013
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