Organization
CUMEDICA DOCTORS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYRA LOPEZ MD (OWNER)
(813) 509-8083
Entity
Organization
Contact information
Practice address
4618 N ARMENIA AVE, TAMPA, FL 33603-2706
(813) 997-6042
Mailing address
8904 W HAMILTON AVE, TAMPA, FL 33615-2726
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103116700
—
FL
Enumeration date
04/16/2019
Last updated
10/15/2020
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