Organization
MY DOCTOR MEDICAL GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEJANDRO GONZALEZ (PRESIDENT)
(813) 280-4909
Entity
Organization
Contact information
Practice address
6822 W WATERS AVE, TAMPA, FL 33634-2212
(813) 280-4909
(813) 302-7143
Mailing address
6822 W WATERS AVE, TAMPA, FL 33634-2212
(813) 280-4909
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101345800
—
FL
Enumeration date
03/01/2018
Last updated
10/31/2024
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