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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