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Organization

IMAGES MEDICAL CLINIC PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KASIE RUSSELL APRN (OWNER)
(813) 444-7311
Entity
Organization

Contact information

Practice address
38176 MEDICAL CENTER AVE, ZEPHYRHILLS, FL 33540-1380
(813) 444-7311
(813) 488-0011
Mailing address
PO BOX 7062, WESLEY CHAPEL, FL 33545-0100
(813) 444-7311
(813) 488-0011

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
363LA2200X
Adult Health Nurse Practitioner
Primary
363LP2300X
Primary Care Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9268544
APRN
FL
Enumeration date
11/20/2020
Last updated
03/07/2023
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