Organization
DAVITA MEDICAL FLORIDA, INC.
Active
Organization
DAVITA MEDICAL FLORIDA, INC.
Active
Other names
DaVita Medical Group, Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES HILGER (CHIEF ACCOUNTING OFFICER)
(253) 973-0777
Entity
Organization
Contact information
Practice address
11920 SEMINOLE BLVD, LARGO, FL 33778-2803
(727) 828-0378
(727) 828-0390
Mailing address
10051 5TH STREET NORTH, ST. PETERSBURG, FL 33702-2299
(727) 828-0378
(727) 828-0390
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH20947
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028343600
—
FL
01
—
2003983
PK
—
Enumeration date
12/11/2006
Last updated
05/10/2017
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