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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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