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
2727 W DR MARTIN LUTHER KING JR BLVD STE 100, STE 100, TAMPA, FL 33607-6353
(813) 871-2826
(813) 876-3450
Mailing address
10051 5TH STREET NORTH, ST. PETERSBURG, FL 33702-2299
(813) 871-2826
(813) 876-3450
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH18510
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030814500
—
FL
01
—
2014553
PK
—
Enumeration date
12/11/2006
Last updated
05/10/2017
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