Organization
BRANDON MEDICAL CARE LLC
Active
Other names
Brandon Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
SHITAL MEHTA D.O. (OWNER)
(813) 734-8939
Entity
Organization
Contact information
Practice address
143 N OAKWOOD AVE, BRANDON, FL 33510-4629
(813) 734-8939
Mailing address
6328 GUNN HWY STE B33624, TAMPA, FL 33625-4101
(813) 964-8526
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800270806
—
FL
05
—
861112772
—
FL
Enumeration date
08/28/2019
Last updated
04/22/2021
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