Organization
DOCTORS MEDICAL CLINICS OF TAMPA, LLC
Active
Organization
DOCTORS MEDICAL CLINICS OF TAMPA, LLC
Active
Other names
DOCTORS MEDICAL CLINICS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WISDOM K DARKO HRM (MANAGER/OWNER)
(813) 988-8380
Entity
Organization
Contact information
Practice address
10770 N 46TH ST STE B300, TAMPA, FL 33617-3488
(813) 988-8380
(813) 988-8423
Mailing address
10770 N 46TH ST STE B300, TAMPA, FL 33617-3488
(813) 988-8380
(813) 988-8423
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
HCC8997
FL
261QP3300X
Pain Clinic/Center
Primary
PMC1035
FL
302R00000X
Health Maintenance Organization
HCC8997
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EZ293A
MEDICARE
FL
01
—
HCC8997
AHCA
FL
Enumeration date
02/03/2011
Last updated
05/02/2018
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