Organization
MD MEDICARE CHOICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE ESPARRA CANSOBRE (CHIEF FINANCIAL OFFICER)
18139019208
Entity
Organization
Contact information
Practice address
5501 W WATERS AVE, SUITE 401, TAMPA, FL 33634-1229
(813) 901-9208
(813) 901-9209
Mailing address
5501 W WATERS AVE, SUITE 401, TAMPA, FL 33634-1229
(813) 901-9208
(813) 901-9209
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
H5729
FL
Other
Enumeration date
12/20/2007
Last updated
12/20/2007
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