Organization
CLINICAID WELL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGIO CEBALLOS LMT (OWNER)
(813) 874-2737
Entity
Organization
Contact information
Practice address
3619 HENDERSON BLVD, TAMPA, FL 33609-4501
(813) 874-2737
(813) 874-0099
Mailing address
3619 HENDERSON BLVD, TAMPA, FL 33609-4501
(813) 874-2737
(813) 874-0099
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
HCC8834
FL
Other
Enumeration date
01/12/2011
Last updated
01/12/2011
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