Organization
WEST WATERS MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERTO PORTAL (MANAGER)
(813) 734-9218
Entity
Organization
Contact information
Practice address
3550 W WATERS AVE, SUITE 108, TAMPA, FL 33614-2716
(813) 734-9218
(813) 374-9221
Mailing address
3550 W WATERS AVE, SUITE 108, TAMPA, FL 33614-2716
(813) 734-9218
(813) 374-9221
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
HCC7342
FL
Other
Enumeration date
03/31/2009
Last updated
03/31/2009
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