Organization
EL SOL MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JULIO MARTINEZ CARDENAS (AUTHORIZED OFFICAL)
(813) 546-6693
Entity
Organization
Contact information
Practice address
2511 W VIRGINIA AVE, TAMPA, FL 33607-6310
(813) 350-0051
(813) 350-0053
Mailing address
2511 W VIRGINIA AVE, TAMPA, FL 33607-6310
(813) 350-0051
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC12060
ACHA LICENSE
FL
Enumeration date
09/09/2020
Last updated
05/10/2021
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