Organization
PROMEDTC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYMUR CHEPI-IPA APRN-C (MEDICAL DIRECTOR)
(718) 666-8759
Entity
Organization
Contact information
Practice address
3109 LITHIA PINECREST RD, VALRICO, FL 33596-5632
(718) 666-8759
Mailing address
777 N ASHLEY DR UNIT 1815, TAMPA, FL 33602-4373
(718) 666-8759
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548623432
NPI
FL
Enumeration date
06/10/2020
Last updated
06/10/2020
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