Organization
FLORIDA MEDICAL CLINIC, LLC
Active
Parent organization
FLORIDA MEDICAL CLINIC , LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA MEDICAL CLINIC , LLC
Authorized official
JOE I DELATORRE (CEO)
(813) 780-8440
Entity
Organization
Contact information
Practice address
17401 COMMERCE PARK BLVD STE 107, TAMPA, FL 33647-3507
(813) 782-8311
Mailing address
38135 MARKET SQUARE, ZEPHYRHILLS, FL 33542
(813) 780-1255
(813) 780-9773
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800006196
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
690006221
RR MEDICARE
FL
Enumeration date
04/08/2006
Last updated
02/21/2020
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